Inestabilidad anterior de la rodilla: utilidad del artrómetro KT 1000
Anterior instability of the knee: usefulness of the KT 1000 arthrometer
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Sanmiguel, A. (2011). Inestabilidad anterior de la rodilla: utilidad del artrómetro KT 1000. Revista Repertorio De Medicina Y Cirugía, 20(1), 7–11. https://doi.org/10.31260/RepertMedCir.v20.n1.2011.664
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Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0.
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La articulación laxa cursa con aumento de los arcos de movimiento, pero ante una demasiado laxa se corre el riesgo de luxación o subluxación. En la rodilla la estabilidad pasiva está dada por varios factores, entre los cuales figuran los complejos ligamentarios; de ellos el ligamento cruzado anterior que es estabilizador anterior y rotacional es el que con mayor frecuencia se lesiona. Su falla funcional ocasiona inestabilidad anterolateral que se asocia a mediano y largo plazo con artrosis y otras lesiones. La prueba de Lachman tiene alta sensibilidad y especificidad para el diagnóstico clínico, pero no ha demostrado ser útil para el control y seguimiento dado que su cuantificación es subjetiva. En la década de los ochenta aparecen equipos que pretenden cuantificar la estabilidad de la rodilla, como el KT 1000 ( MedMetric, San Diego, CA, USA). Este dispositivo es delicado, presenta alta variabilidad interobservador e interprueba, y los resultados reflejan la laxitud articular pero deben interpretarse con prudencia. Es una herramienta válida y útil en la valoración y seguimiento de la inestabilidad anterior de rodilla.
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3. Insall JN, Scott WN. Insall and Scott surgery of the knee. 4th ed. Philadelphia: Church Livingstone ; Elsevier, c2006.
4. Fu FH, Harner CD. Knee surgery. Baltimore: Williams and Wilkins, 1994.
5. Biomechanics of joints. In: Nordin M, Frankel VH. Basic biomechanics of the musculoskeletal system. 3rd ed. Philadelphia: Lippincott Williams and Wilkins; 2001.
6. Barber FA, McGarry JE. Meniscal repair techniques. Sports Med Arthrosc. 2007 Dec; 15(4):199-207.
7. van der Wal RJ, Thomassen BJ, van Arkel ER. Long-term clinical outcome of open meniscal allograft transplantation. Am J Sports Med. 2009 Nov; 37(11):2134-9.
8. Greis PE, Bardana DD, Holmstrom MC, Burks RT. Meniscal injury : I. Basic science and evaluation. J Am Acad Orthop Surg. 2002 May- Jun;10(3):168-76.
9. Alford JW, Cole BJ. Cartilage restoration, part 1: basic science, historical perspective, patient evaluation, and treatment options. Am J Sports Med. 2005 Feb; 33(2):295-306.
10. Moore KL, Dalley AF. Anatomía con orientación clínica. 5ª ed. México : Panamericana; 2007.
11. Veltri DM, Warren RF. Isolated and combined posterior cruciate ligament injuries. J Am Acad Orthop Surg. 1993 Nov;1(2):67-75.
12. Wind WM Jr, Bergfeld JA, Parker RD. Evaluation and treatment of posterior cruciate ligament injuries. Am J Sports Med. 2004 Oct-Nov;32(7):1765-75.
13. Cosgarea AJ, Jay PR. Posterior cruciate ligament injuries: evaluation and management. JAm Acad Orthop Surg. 2001 Sep-Oct; 9(5):297-307.
14. Amis AA, Dawkins GP. Funtional anatomy of the anterior cruciate ligament. Fibre bundle actions related to ligament replacements and injuries. J Bone Joint Surg Br. 1991 Mar; 73(2): 260-7.
15. Takahashi M, Doi M, Abe M, Suzuki D, Nagano A. Anatomical study of the femoral and tibial insertions of the anteromedial and posterolateral bundles of human anterior cruciate ligament. Am J Sports Med. 2006 May;34(5):787-92.
16. Colombet P, Robinson J, Jambou S, Allard M, Bousquet V, de Lavigne C. Two-bundle, four-tunnel anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2006 Jul;14(7):629-36.
17. Louboutin H, Debarge R, Richou J, Selmi TA, Donell ST, Neyret P, Dubrana F. Review Osteoarthritis in patients with anterior cruciete ligament rupture: a review of risk factors. Knee. 2009 Aug;16(4):239-44.
18. Seebacher JR, Inglis AE, Marshall JL, Warren RF. The structure of the posterolateral aspect of the knee. J Bone Joint Surg Am. 1982 Apr; 64(4):536-41.
19. Chen FS, Rokito AS, Pitman MI. Acute and chronic posterolateral rotator instability of the knee. JAm Acad Orthop Surg. 2000 Mar-Apr; 8(2):97-110.
20. LaPrade RF, Engebretsen AH, Ly TV, Johansen S, Wentorf FA, Engebretsen
L. The anatomy of the medial part of the knee. J Bone Joint Surg Am. 2007 Sep;89(9):2000-10.
21. Muneta T, Sekiya I, Yagishita K, Ogiuchi T, Yamanoto H, Shinomiya K. Two-bundle reconstruction of the anterior cruciate ligament using semitendinosus tendon with endobuttons: operative technique and preliminary results. Arthroscopy. 1999 Sep;15(6):618-24.
22. Beynnon BD, Johnson RJ, Abate JA, Fleming BC, Nichols CE. Treatment of anterior cruciate ligament injuries, part I.. Am J Sports Med. 2005 Oct;33(10):1579-602.
23. Arendt E, Dick R. Knee injury patterns among men and women in collegiate basketball and soccer: NCAA data and review of literature. Am J Sports Med. 1995 Nov-Dec;23(6):694-701.
24. Zantop T, Petersen W, Fu FH. Anatomy of the anterior cruciate ligament. Oper Tech Orthop [serie en Internet]. 2005 [citado 2011 Feb 10]; 15 : [aprox. 9 p.]. Disponible en: http://homepage3.nifty.com/h_sports_clinic/ ACL%20anatomy%20reference.pdf
25. Biau DJ, Katsahian S, Kartus J, Harilainen A, et al. Patellar tendon versus hamstring tendon autografts for reconstructing the anterior cruciate ligament: a meta-analysis based on individual patient data . Am J Sports Med. 2009 Dec;37(12):2470-8.
26. DeFranco MJ, Bach BR Jr. Acomprehensive review of partial anterior cruciate ligament tears. J Bone Joint Surg Am. 2009 Jan;91(1):198-208.
27. Bray RC, Dandy DJ. Meniscal lesions and chronic anterior cruciate ligament deficiency. Meniscal tears occurring before and after reconstruction . J Bone Joint Surg Br. 1989 Jan; 71(1):128-30.
28. Noyes FR, Bassett RW, Grood ES, Butler DL. Arthroscopy in acute traumatic hemarthrosis of the knee. Incidence of anterior cruciate tears and other inju- ries. J Bone Joint Surg Am. 1980 Jul; 62(5):687-95, 757.
29. Louboutin H, Debarge R, Richou J, Selmi TA, Donell ST, Neyret P, Dubrana F. Osteoarthritis in patients with anterior cruciate ligament rupture: a review of risk factors. Knee. 2009 Aug; 16(4):239-44.
30. Shelbourne KD, Gray T. Results of anterior cruciate ligament reconstruction based on meniscus and articular cartilage status at the time of surgery. Five- to fifteen-year evaluations. Am J Sports Med. 2000 Jul-Aug;28(4):446-52.
31. Magee D. Ortopedia. 2ª ed. México: Interamericana McGraw-Hill; 1994.
32. Skinner HB. Diagnostico y tratamiento en ortopedia. 3ª ed. México : Manual Moderno; 2005.
33. Lubowitz JH, Bernardini BJ, Reid JB. Current concepts review: comprehensive physical examination for instability of the knee. Am J Sports Med. 2008 Mar;36(3):577-94.
34. Lohmander LS, Englund PM, Dahl LL, Roos EM. The long-term consequence of anterior cruciate ligament and meniscus injuries. Am J Sports Med. 2007 Oct;35(10):1756-69.
35. Fanelli GC, Orcutt DR, Edson CJ. The multiple-ligament injured knee: evaluation, treatment and results. Arthroscopy. 2005 Apr; 21(4):471-86.
36. Lopomo N, Bignozzi S, Martelli S, Zaffagnini S, Iacono F, Visani A, Marcacci M. Reliability of a navigation system for intra – operative evaluation of antero-posterior knee joint laxity. Comput Biol Med. 2009 Mar;39(3):280-5.
37. Robert H, Nouveau S, Gageot S, Gagnière B. A new knee arthrometer, the GNRB: Experience in ACL complete and partial tears. Orthop Traumatol Surg Res. 2009 May; 95(3):171-6.
38. Daniel DM, Malcom LL, Losse G, Stone ML, Sachs R, Burks R. Instrumented measurement of anterior laxity of the knee. J Bone Joint Surg Am. 1985 Jun;67(5):720-6.
39. Malcom LL, Daniel DM, Stone ML, Sachs R. The measurement of anterior knee laxity after ACL reconstructive surgery. Clin Orthop Relat Res. 1985 Jun;(196):35-41.
40. Kowalk DL, Wojtys EM, Disher J, Loubert P. Quantitative analysis of the measuring capabilities of the KT-1000 knee ligament arthrometer. Am J Sports Med. 1993 Sep-Oct;21(5):744-7.
41. Wiertsema SH, van Hooff HJ, Migchelsen LA, Steultjens MP. Reliability of the KT1000 arthrometer and the Lachman test in patients with an ACL rupture. Knee. 2008 Mar;15(2):107-10.
42. Arneja S, Leith J. Review article: Validity of the KT-1000 knee ligament arthrometer. J Orthop Surg (Hong Kong). 2009 Apr; 17(1):77-9.
43. instrumented measurement of de knee motion. In: Daniel DM, Akerson WH, O´Connor JJ, editors. Knee ligaments: structure, function, injury and repair. New York: Raven Press, c1990. p. 421-426.
44. Highgenboten CL, Jackson AW, Jansson KA, Meske NB. KT-1000 arthrometer: conscious and undconscious test results using 15,20,and 30 pounds of force. Am J Sports Med. 1992 Jul-Aug; 20(4):450-4.
45. Cannon W, Dilworth MD. Use of arthrometers to assess knee laxity and outcomes. Sports Med Arthrosc. 2002 Sep; 10(2) 191-200.
46. Forster IW, Warren-Smith CD, Tew M. Is the KT 1000 knee ligament arthrometer reliable?. J Bone Joint Surg Br. 1989 Nov; 71(5):843-7.
47. Highgenboten CL, Jackson A, Meske NB. Genucom, KT 1000 and Stryker knee laxity measuring device comparisons. Device Reproducibility and interdevice comparison in asymptomatic subjects. Am J Sports Med. 1989 Nov-Dec;17(6):743-6.
48. Giannotti BF, Fanelli GC, Barrett TA, Edson C. The predictive value of intraoperative KT-1000 arthrometer measurements in single incision anterior cruciate ligament reconstruction. Arthroscopy. 1996 Dec; 12(6):660-6.
49. DeFranco MJ, Bach BR Jr. Acomprehensive review of partial anterior cruciate ligament tears. J Bone Joint Surg Am. 2009 Jan;91(1):198-208.
50. Birmingham TB, Bryant DM, Giffin JR, et al. A randomized controlled trial comparing the effectiveness of functional knee brace and neoprene sleeve use after anterior cruciate ligament reconstruction. Am J Sports Med. 2008 Apr; 36(4):648-55.
51. Casalonga A, Bourelle S, Chalencon F, De Oliviera L, Gautheron V, Cottalorda J. Tibial intercondylar eminence fractures in children: the long-term perspective. Orthop Traumatol Surg Res. 2010 Jun 10.
2. . Maffulli N. Laxity versus instability. Orthopedics. 1998 Aug;21(8): 837, 842.
3. Insall JN, Scott WN. Insall and Scott surgery of the knee. 4th ed. Philadelphia: Church Livingstone ; Elsevier, c2006.
4. Fu FH, Harner CD. Knee surgery. Baltimore: Williams and Wilkins, 1994.
5. Biomechanics of joints. In: Nordin M, Frankel VH. Basic biomechanics of the musculoskeletal system. 3rd ed. Philadelphia: Lippincott Williams and Wilkins; 2001.
6. Barber FA, McGarry JE. Meniscal repair techniques. Sports Med Arthrosc. 2007 Dec; 15(4):199-207.
7. van der Wal RJ, Thomassen BJ, van Arkel ER. Long-term clinical outcome of open meniscal allograft transplantation. Am J Sports Med. 2009 Nov; 37(11):2134-9.
8. Greis PE, Bardana DD, Holmstrom MC, Burks RT. Meniscal injury : I. Basic science and evaluation. J Am Acad Orthop Surg. 2002 May- Jun;10(3):168-76.
9. Alford JW, Cole BJ. Cartilage restoration, part 1: basic science, historical perspective, patient evaluation, and treatment options. Am J Sports Med. 2005 Feb; 33(2):295-306.
10. Moore KL, Dalley AF. Anatomía con orientación clínica. 5ª ed. México : Panamericana; 2007.
11. Veltri DM, Warren RF. Isolated and combined posterior cruciate ligament injuries. J Am Acad Orthop Surg. 1993 Nov;1(2):67-75.
12. Wind WM Jr, Bergfeld JA, Parker RD. Evaluation and treatment of posterior cruciate ligament injuries. Am J Sports Med. 2004 Oct-Nov;32(7):1765-75.
13. Cosgarea AJ, Jay PR. Posterior cruciate ligament injuries: evaluation and management. JAm Acad Orthop Surg. 2001 Sep-Oct; 9(5):297-307.
14. Amis AA, Dawkins GP. Funtional anatomy of the anterior cruciate ligament. Fibre bundle actions related to ligament replacements and injuries. J Bone Joint Surg Br. 1991 Mar; 73(2): 260-7.
15. Takahashi M, Doi M, Abe M, Suzuki D, Nagano A. Anatomical study of the femoral and tibial insertions of the anteromedial and posterolateral bundles of human anterior cruciate ligament. Am J Sports Med. 2006 May;34(5):787-92.
16. Colombet P, Robinson J, Jambou S, Allard M, Bousquet V, de Lavigne C. Two-bundle, four-tunnel anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2006 Jul;14(7):629-36.
17. Louboutin H, Debarge R, Richou J, Selmi TA, Donell ST, Neyret P, Dubrana F. Review Osteoarthritis in patients with anterior cruciete ligament rupture: a review of risk factors. Knee. 2009 Aug;16(4):239-44.
18. Seebacher JR, Inglis AE, Marshall JL, Warren RF. The structure of the posterolateral aspect of the knee. J Bone Joint Surg Am. 1982 Apr; 64(4):536-41.
19. Chen FS, Rokito AS, Pitman MI. Acute and chronic posterolateral rotator instability of the knee. JAm Acad Orthop Surg. 2000 Mar-Apr; 8(2):97-110.
20. LaPrade RF, Engebretsen AH, Ly TV, Johansen S, Wentorf FA, Engebretsen
L. The anatomy of the medial part of the knee. J Bone Joint Surg Am. 2007 Sep;89(9):2000-10.
21. Muneta T, Sekiya I, Yagishita K, Ogiuchi T, Yamanoto H, Shinomiya K. Two-bundle reconstruction of the anterior cruciate ligament using semitendinosus tendon with endobuttons: operative technique and preliminary results. Arthroscopy. 1999 Sep;15(6):618-24.
22. Beynnon BD, Johnson RJ, Abate JA, Fleming BC, Nichols CE. Treatment of anterior cruciate ligament injuries, part I.. Am J Sports Med. 2005 Oct;33(10):1579-602.
23. Arendt E, Dick R. Knee injury patterns among men and women in collegiate basketball and soccer: NCAA data and review of literature. Am J Sports Med. 1995 Nov-Dec;23(6):694-701.
24. Zantop T, Petersen W, Fu FH. Anatomy of the anterior cruciate ligament. Oper Tech Orthop [serie en Internet]. 2005 [citado 2011 Feb 10]; 15 : [aprox. 9 p.]. Disponible en: http://homepage3.nifty.com/h_sports_clinic/ ACL%20anatomy%20reference.pdf
25. Biau DJ, Katsahian S, Kartus J, Harilainen A, et al. Patellar tendon versus hamstring tendon autografts for reconstructing the anterior cruciate ligament: a meta-analysis based on individual patient data . Am J Sports Med. 2009 Dec;37(12):2470-8.
26. DeFranco MJ, Bach BR Jr. Acomprehensive review of partial anterior cruciate ligament tears. J Bone Joint Surg Am. 2009 Jan;91(1):198-208.
27. Bray RC, Dandy DJ. Meniscal lesions and chronic anterior cruciate ligament deficiency. Meniscal tears occurring before and after reconstruction . J Bone Joint Surg Br. 1989 Jan; 71(1):128-30.
28. Noyes FR, Bassett RW, Grood ES, Butler DL. Arthroscopy in acute traumatic hemarthrosis of the knee. Incidence of anterior cruciate tears and other inju- ries. J Bone Joint Surg Am. 1980 Jul; 62(5):687-95, 757.
29. Louboutin H, Debarge R, Richou J, Selmi TA, Donell ST, Neyret P, Dubrana F. Osteoarthritis in patients with anterior cruciate ligament rupture: a review of risk factors. Knee. 2009 Aug; 16(4):239-44.
30. Shelbourne KD, Gray T. Results of anterior cruciate ligament reconstruction based on meniscus and articular cartilage status at the time of surgery. Five- to fifteen-year evaluations. Am J Sports Med. 2000 Jul-Aug;28(4):446-52.
31. Magee D. Ortopedia. 2ª ed. México: Interamericana McGraw-Hill; 1994.
32. Skinner HB. Diagnostico y tratamiento en ortopedia. 3ª ed. México : Manual Moderno; 2005.
33. Lubowitz JH, Bernardini BJ, Reid JB. Current concepts review: comprehensive physical examination for instability of the knee. Am J Sports Med. 2008 Mar;36(3):577-94.
34. Lohmander LS, Englund PM, Dahl LL, Roos EM. The long-term consequence of anterior cruciate ligament and meniscus injuries. Am J Sports Med. 2007 Oct;35(10):1756-69.
35. Fanelli GC, Orcutt DR, Edson CJ. The multiple-ligament injured knee: evaluation, treatment and results. Arthroscopy. 2005 Apr; 21(4):471-86.
36. Lopomo N, Bignozzi S, Martelli S, Zaffagnini S, Iacono F, Visani A, Marcacci M. Reliability of a navigation system for intra – operative evaluation of antero-posterior knee joint laxity. Comput Biol Med. 2009 Mar;39(3):280-5.
37. Robert H, Nouveau S, Gageot S, Gagnière B. A new knee arthrometer, the GNRB: Experience in ACL complete and partial tears. Orthop Traumatol Surg Res. 2009 May; 95(3):171-6.
38. Daniel DM, Malcom LL, Losse G, Stone ML, Sachs R, Burks R. Instrumented measurement of anterior laxity of the knee. J Bone Joint Surg Am. 1985 Jun;67(5):720-6.
39. Malcom LL, Daniel DM, Stone ML, Sachs R. The measurement of anterior knee laxity after ACL reconstructive surgery. Clin Orthop Relat Res. 1985 Jun;(196):35-41.
40. Kowalk DL, Wojtys EM, Disher J, Loubert P. Quantitative analysis of the measuring capabilities of the KT-1000 knee ligament arthrometer. Am J Sports Med. 1993 Sep-Oct;21(5):744-7.
41. Wiertsema SH, van Hooff HJ, Migchelsen LA, Steultjens MP. Reliability of the KT1000 arthrometer and the Lachman test in patients with an ACL rupture. Knee. 2008 Mar;15(2):107-10.
42. Arneja S, Leith J. Review article: Validity of the KT-1000 knee ligament arthrometer. J Orthop Surg (Hong Kong). 2009 Apr; 17(1):77-9.
43. instrumented measurement of de knee motion. In: Daniel DM, Akerson WH, O´Connor JJ, editors. Knee ligaments: structure, function, injury and repair. New York: Raven Press, c1990. p. 421-426.
44. Highgenboten CL, Jackson AW, Jansson KA, Meske NB. KT-1000 arthrometer: conscious and undconscious test results using 15,20,and 30 pounds of force. Am J Sports Med. 1992 Jul-Aug; 20(4):450-4.
45. Cannon W, Dilworth MD. Use of arthrometers to assess knee laxity and outcomes. Sports Med Arthrosc. 2002 Sep; 10(2) 191-200.
46. Forster IW, Warren-Smith CD, Tew M. Is the KT 1000 knee ligament arthrometer reliable?. J Bone Joint Surg Br. 1989 Nov; 71(5):843-7.
47. Highgenboten CL, Jackson A, Meske NB. Genucom, KT 1000 and Stryker knee laxity measuring device comparisons. Device Reproducibility and interdevice comparison in asymptomatic subjects. Am J Sports Med. 1989 Nov-Dec;17(6):743-6.
48. Giannotti BF, Fanelli GC, Barrett TA, Edson C. The predictive value of intraoperative KT-1000 arthrometer measurements in single incision anterior cruciate ligament reconstruction. Arthroscopy. 1996 Dec; 12(6):660-6.
49. DeFranco MJ, Bach BR Jr. Acomprehensive review of partial anterior cruciate ligament tears. J Bone Joint Surg Am. 2009 Jan;91(1):198-208.
50. Birmingham TB, Bryant DM, Giffin JR, et al. A randomized controlled trial comparing the effectiveness of functional knee brace and neoprene sleeve use after anterior cruciate ligament reconstruction. Am J Sports Med. 2008 Apr; 36(4):648-55.
51. Casalonga A, Bourelle S, Chalencon F, De Oliviera L, Gautheron V, Cottalorda J. Tibial intercondylar eminence fractures in children: the long-term perspective. Orthop Traumatol Surg Res. 2010 Jun 10.
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