Picture of smart phone in human hand

World leading smartphone and mobile technology research at Strathclyde...

The Strathprints institutional repository is a digital archive of University of Strathclyde's Open Access research outputs. Strathprints provides access to thousands of Open Access research papers by University of Strathclyde researchers, including by Strathclyde researchers from the Department of Computer & Information Sciences involved in researching exciting new applications for mobile and smartphone technology. But the transformative application of mobile technologies is also the focus of research within disciplines as diverse as Electronic & Electrical Engineering, Marketing, Human Resource Management and Biomedical Enginering, among others.

Explore Strathclyde's Open Access research on smartphone technology now...

How important is flexion angle during collateral stress testing of the knee?

Clarke, J.V. and Spencer, S.J. and Deakin, A.H. and Picard, F. and Riches, P.E. (2012) How important is flexion angle during collateral stress testing of the knee? Journal of Bone and Joint Surgery, British Volume, 94-B (Supp X). p. 40. ISSN 0301-620X

Full text not available in this repository. Request a copy from the Strathclyde author

Abstract

Assessment of coronal knee laxity via manual stress testing is commonly performed during joint examination. While it is generally accepted that the knee should be flexed slightly to assess its collateral restraints, the importance of the exact degree of flexion at time of testing has not been documented. The aim of this study therefore was to assess the effect of differing degrees of knee flexion on the magnitude of coronal deflection observed during collateral stress testing.Using non-invasive infrared technology, the real-time coronal and sagittal mechanical femorotibial (MFT) angles of three asymptomatic volunteers were measured. A single examiner, blinded to the real-time display of coronal but not sagittal alignment, held the knee in maximum extension and performed manual varus and valgus stress manoeuvres to a perceived end-point. This sequence was repeated at 5° increments up to 30° of flexion. This provided unstressed, varus and valgus coronal alignment measurements as well as overall envelope of laxity (valgus angle – varus angle) which were subsequently regressed against knee flexion.Regression analysis indicated that all regression coefficients were significantly different to zero (p <0.001). With increasing knee flexion, valgus MFT angles became more valgus and varus MFT angles became more. The overall laxity of the knee in the coronal plane increased approximately fourfold with 30° of knee flexion.The results demonstrated that small changes in knee flexion could result in significant changes in coronal knee laxity, an observation which has important clinical relevance and applications. For example the assessment of medial collateral ligament (MCL) injuries can be based on the perceived amount of joint opening with no reference made to knee flexion at time of assessment. Therefore, close attention should be paid to the flexion angle of the knee during stress testing in order to achieve a reliable and reproducible assessment.