The Intrarater and Interrater Reliability and Validity of Universal Goniometer, Digital Inclinometer, and Smartphone Application Measuring Range of Motion in Patients with Total Knee Arthroplasty.

Objectives: The aim of this study was to investigate the intrarater and interrater reliability and validity of range of motion measurements obtained with a universal goniometer, digital inclinometer, and smartphone application in patients with total knee arthroplasty. Methods: Range of motion of the knee joint was measured by two examiners with a universal goniometer, digital inclinometer, and a smartphone application. Data were obtained from 51 knees of 27 patients at postoperative 6 months. Two measurements made by the first examiner were compared to assess interrater reliability, and measurements from both examiners were compared to assess intrarater reliability. Statistical analysis was performed using intraclass correlation coefficient (ICC) and Spearman's rho values. Results: With all three methods, active and passive knee flexion range of motion measurements showed high intrarater and interrater reliability (ICC = 0.749-0.949). Concurrent validity analysis also demonstrated statistically significant, moderate to strong correlation among the three methods (r = 0.775-0.941). Conclusion: The universal goniometer, digital inclinometer, and smartphone application were all found to be reliable and valid assessment tools in clinical practice for patients with total knee arthroplasty.

Autologous free iliac crest bone grafting of glenoid through the rotator interval using double-barrelled cannula.

PURPOSE: The primary aim of this study is to prove that reconstructing the anterior glenoid defect with iliac crest graft arthroscopically using double-barrelled cannula through the rotator interval is safe and prevents both recurrence of instability and the neurovascular injury because subscapularis muscle is not split and procedure is far away from important structures. METHODS: Thirteen patients with anterior shoulder instability and engaging Hill-Sachs lesion were reviewed after arthroscopic reconstruction of the anterior glenoid with iliac crest autogenous graft. Patient satisfaction and Western Ontario Instability Score (WOSI) were evaluated on clinical examination. Computed tomography was used to analyse graft position on sagittal and axial planes. RESULTS: The mean follow-up was 28.7 months (SD 7.1), and age at surgery was 31 years (21 to 64 years). Post-operatively there was only one dislocation due to trauma. There was statistically significant improvement of WOSI scores (p: 0.001). There was not any neurological injury. Graft position on the axial plane was described as flush in 5 cases (41%), lateral in 2 (16%), too lateral in one (8%) and medial in 4 of the cases (33%). Graft position could be accepted as high in only three patients (23%). CONCLUSION: Arthroscopic reconstruction of glenoid defect using autogenous iliac bone graft, through rotator interval, without splitting subscapularis is safe and effective without any neurological injury, producing substantial graft position and good functional outcomes in patients.

Reliability of the Modified Four Square Step Test (mFSST) in patients with primary total knee arthroplasty.

Purpose: The aim of the present study was to determine the test-retest reliability of the modified four square step test (mFSST) in patients with primary total knee arthroplasty (TKA).Methods: Twenty-eight patients with primary TKA were included in this study. Patients performed two mFSST trials on the same day.Results: The mFSST showed excellent test-retest reliability in this study. Intraclass correlation coefficient [ICC(2,1)] for FSST was 0.97. Standard error of measurement and smallest real difference at the 95% confidence level for mFSST were 0.80 and 2.24, respectively.Conclusions: The mFSST has an excellent test-retest reliability in patients with primary TKA. It is an effective and reliable tool for measuring dynamic balance and mobility in patients with primary TKA. As a clinical test, the mFSST is easy to score, quick to administer, requires little space, has no cost and needs no special equipment.

Reliability of 3-m Backward Walk Test in Patients with Primary Total Knee Arthroplasty.

The 3-m backward walk test (3MBWT) is used to evaluate neuromuscular control, proprioception, protective reflexes, fall risk, and balance. The aim of the present study was to determine the test-retest reliability of the 3MBWT in patients with primary total knee arthroplasty (TKA). Twenty-eight patients with primary TKA, operated by the same surgeon, were included in this study. Patients performed trials for 3MBWT twice on the same day. Between the first and second trials, patients waited for an hour on sitting position to prevent fatigue. The 3MBWT showed an excellent test-retest reliability in this study. Intraclass correlation coefficient (ICC) for 3MBWT was 0.97. The standard error of measurement and smallest real difference at the 95% confidence level for 3MBWT were 1.06 and 2.94, respectively. The 3MBWT has an excellent test-retest reliability in patients with primary TKA. It is an effective and reliable tool for measuring dynamic balance and participant falls. As a clinical test, the 3MBWT is easy to score, requires little space, has no cost, needs no special equipment, and can be applied in a short time as part of the routine medical examination.