The Influence of Tibial Positioning on the Diagnostic Accuracy of Combined Posterior Cruciate Ligament and Posterolateral Rotatory Instability of the Knee.
- Author:
Young Bok JUNG
1
;
Chang Hyun NAM
;
Ho Joong JUNG
;
Yong Seuk LEE
;
Young Bong KO
Author Information
- Publication Type:Original Article
- Keywords: Posterolateral rotatory instability; Dial test; Thigh-foot angle
- MeSH: Adolescent; Adult; Biomechanics; Female; Humans; Joint Instability/*diagnosis/physiopathology; Knee Joint/*physiopathology; Male; Middle Aged; *Physical Examination; Posterior Cruciate Ligament/*injuries/physiopathology; Range of Motion, Articular; Tibia/*physiopathology; Young Adult
- From:Clinics in Orthopedic Surgery 2009;1(2):68-73
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND: To determine if tibial positioning affects the external rotation of the tibia in a dial test for posterolateral rotatory instability combined with posterior cruciate ligament (PCL) injuries. METHODS: Between April 2007 and October 2007, 16 patients with a PCL tear and posterolateral rotatory instability were diagnosed using a dial test. The thigh-foot angle was measured at both 30degrees and 90degrees of knee flexion with an external rotation stress applied to the tibia in 2 different positions (reduction and posterior subluxation). The measurements were performed twice by 2 orthopedic surgeons. RESULTS: In posterior subluxation, the mean side-to-side difference in the thigh-foot angle was 11.56 +/- 3.01degrees at 30degrees of knee flexion and 11.88 +/- 4.03degrees at 90degrees of knee flexion. In the sequential dial test performed with the tibia reduced, the mean side-to-side difference was 15.94 +/- 4.17degrees (p < 0.05) at 30degrees of knee flexion and 16.88 +/- 4.42degrees (p = 0.001) at 90degrees of knee flexion. The mean tibial external rotation was 5.31 +/- 2.86degrees and 6.87 +/- 3.59degrees higher in the reduced position than in the posterior subluxation at both 30degrees and 90degrees of knee flexion. CONCLUSIONS: In the dial test, reducing the tibia with an anterior force increases the ability of an examiner to detect posterolateral rotary instability of the knee combined with PCL injuries.
