DYNEELAX Robotic Arthrometer Reliability and Feasibility on Healthy and Anterior Cruciate Ligament Injured/Reconstructed Persons

Abstract

Background: Anterior cruciate ligament (ACL) injuries are commonly assessed using clinical examination and magnetic resonance imaging, but these methods have limitations in reproducibility and quantification. Instrumented laxity measurements using devices, like the DYNEELAX®, offer an alternative approach. However, to date, there is no human data on the DYNEELAX® and the reliability of these devices remains a subject of debate, and there is no consensus on appropriate knee tightening levels for testing. We hypothesized that the DYNEELAX®, with standardized knee tightening, would provide reliable measurements of knee laxity in adult volunteers. Methods: This prospective cohort study involved 48 pain-free adult volunteers. Laxity measurements were taken using a robotic-type motorized instrument (DYNEELAX®) on two separate occasions, at least 1 h and no more than 8 h apart, with knee tightening forces of 90 N ± 5 N. Metrics of anterior tibial translation and internal/external tibial axial rotations were recorded. Results: The device displayed excellent intrarater reliability for all the metrics, with intraclass correlation coefficients ranging from 0.91 to 0.96. Anterior translation exhibited the highest reliability (intraclass correlation coefficient = 0.96), with a minimum detectable change of 0.83 mm. Conclusions: DYNEELAX® is reliable in measuring knee laxity in adult volunteers when using standardized stabilizing knee tightening forces of 90 ± 5 N. The most sensitive measurement parameters (in terms of minimum detectable change as a proportion of the observed range) were anterior translation (in mm) at 150 N and secondary compliance.