The evaluation of Rolimeter, KLT, KiRA and KT‐1000 arthrometer in healthy individuals shows acceptable intra‐rater but poor inter‐rater reliability in the measurement of anterior tibial knee translation

• DOI: 10.1007/s00167-021-06540-9
• Publication Date: 2021-03-31T19:03:01Z
• Authors: Armin Runer; Tommaso Roberti d...; Vasco Starke; Alessandra Iltchev; Gernot Felmet; Sepp Braun; Christian Fink; Robert Csapo
• Keywords: 303030 Training science; Joint Instability; KiRA; Knee Joint; Tibia; Anterior Cruciate Ligament Injuries; 303030 Trainingswissenschaft; Reproducibility of Results; Equivalence testing; Knee arthrometer; KLT; Side-to-side difference; 03 medical and health sciences; 0302 clinical medicine; ACL anterior tibial translation; KT1000; Rolimeter; Humans; Knee; Equivalence testing; Lachman Test; Anterior cruciate ligament; Lachman Test

AbstractPurposeTo assess measurement equivalence, inter‐ and intra‐rater reliability, standard error of measurements (SEM) and false positive measurements (FPM) of four different knee arthrometers (KLT,Karl Storz; KiRA, I + ; KT‐1000 MEDmetric Corp; Rolimeter, Aircast) in healthy patients.MethodsFour different investigators (two advanced (AR) and two beginners (BR)) examined 12 participants with healthy knees at two time points with regards to anterior tibial translation (ATT) and side‐to‐side difference (SSD). Test equivalence was assessed using the TOST (two‐one‐sided t test) procedure with ± 1 mm equivalence boundaries. Intraclass correlation coefficients (ICCs) were calculated using two‐way mixed effects models. Furthermore, false positive‐(SSD > 3 mm) and SEMs were assessed.ResultsA total of 2304 Lachman Tests were performed. Between‐rater SSDs were equivalent between AR and BR raters for the Rolimeter only. Inter‐rater ICC values (SSD, ATT) were graded as “poor” to “moderate” for all devices. Equivalent test–retest results were observed for all raters using the Rolimeter, KLT and KT‐1000, whereas measurement consistency with KiRA was given in the advanced examiners group only. Intra‐rater ICC values (Range: SSD, ATT) were graded as “poor” to “moderate” for SSD values and “moderate” to “good” for ATT. SEMs were lowest for the Rolimeter and highest for KiRA. FPM were never obtained with the Rolimeter (0%), twice (2.1%) with the KT‐1000, three times (3.1%) with the KLT and 33 times (34.4%) using KiRA.ConclusionThere is acceptable intra‐rater but poor inter‐rater reliability with all tested arthrometers. Measures of knee laxity are comparable between Rolimeter, KLT and KT‐1000 but higher for KiRA. Clinically, the present study shows that repeated arthrometry measurements should always be performed by the same investigators.