ASSESSMENT OF TIBIAL MOVEMENT DURING THE LACHMAN TEST

J.D. Moorehead; R.K. Kundra; N. Barton-Hanson; S.C. Montgomery

doi:10.1302/0301-620X.88BSUPP_III.0880401d

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ASSESSMENT OF TIBIAL MOVEMENT DURING THE LACHMAN TEST

J.D. Moorehead
R.K. Kundra
N. Barton-Hanson
S.C. Montgomery

ASSESSMENT OF TIBIAL MOVEMENT DURING THE LACHMAN TEST

Moorehead J, Kundra R, Barton-Hanson N, Montgomery S. ASSESSMENT OF TIBIAL MOVEMENT DURING THE LACHMAN TEST. Orthop Procs. 2006;88-B(SUPP_III):401-401. doi:10.1302/0301-620X.88BSUPP_III.0880401d

Moorehead, J.D., et al. “ASSESSMENT OF TIBIAL MOVEMENT DURING THE LACHMAN TEST.” Orthopaedic Proceedings, vol. 88-B, no. SUPP_III, 2006, pp. 401-401., https://doi.org/10.1302/0301-620X.88BSUPP_III.0880401d

Moorehead, J., Kundra, R., Barton-Hanson, N., & Montgomery, S. (2006). ASSESSMENT OF TIBIAL MOVEMENT DURING THE LACHMAN TEST. Orthopaedic Proceedings, 88-B(SUPP_III), 401-401. https://doi.org/10.1302/0301-620X.88BSUPP_III.0880401d

Moorehead, J., Kundra, R., Barton-Hanson, N. and Montgomery, S. (2006) “ASSESSMENT OF TIBIAL MOVEMENT DURING THE LACHMAN TEST.” Orthopaedic Proceedings, 88-B(SUPP_III), pp. 401-401. Available at: https://doi.org/10.1302/0301-620X.88BSUPP_III.0880401d

Moorehead, J.D., R.K. Kundra, N. Barton-Hanson, and S.C. Montgomery. “ASSESSMENT OF TIBIAL MOVEMENT DURING THE LACHMAN TEST.” Orthopaedic Proceedings 88-B, no. SUPP_III (2006): 401-401. https://doi.org/10.1302/0301-620X.88BSUPP_III.0880401d

Moorehead J, Kundra R, Barton-Hanson N, Montgomery S. ASSESSMENT OF TIBIAL MOVEMENT DURING THE LACHMAN TEST. Orthop Procs. 2006 Oct 1;88-B(SUPP_III):401-401. https://doi.org/10.1302/0301-620X.88BSUPP_III.0880401d

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Abstract

Introduction: The Lachman test for anterior cruciate ligament (ACL) deficiency, requires a subjective assessment of joint movement, as the tibia is pulled anteriorly. This study has objectively quantified this movement using a magnetic tracking device.

Materials and Methods: Ten patients aged 21 to 51 years were assessed as having unilateral ACL deficiency with conventional clinical tests. These patients were then reassessed using a magnetic tracking device (Polhemus Fastrak). Patients had magnetic sensors attached around the femoral and tibial mid-shafts using elasticated Velcro straps. The Lachman test was then performed with the patient lying within range of the system’s magnetic source. The test was performed three times on the normal and injured knees of each patient. During the tests, sensor position and orientation data was collected with an accuracy better than 1 mm and 1 degree, respectively. The data was sampled at 10Hz and stored on a computer for post-test analysis. This analysis deduced the tibial displacement resulting from each Lachman pull.

Results: The main Lachman movement is an anterior displacement of the tibia with respect to the femur. The mean anterior movement for the normal knees was 5.6 mm (SD=2.5). By comparison the ACL deficient knees had a mean anterior movement of 10.2 mm (SD=4.2). This is 82 % more. A paired t test of this data showed it to be highly significant with P = 0.005. In addition to the anterior movement, there was also a small proximal tibial movement. In the normal knees the mean movement was 0.7 mm (SD=1.9). In the injured knees the mean movement was 2.1 mm (SD=3.4). However, this difference was not significant (P = 0.12).

Conclusion: This study has quantified the movement produced during the Lachman test for ACL deficiency. The results compare well with reported results from similar arthrometer tests[1]. The main advantage of the magnetic tracker is that its lightweight sensors cause minimal disturbance to the established clinical test. It therefore offers a convenient and non-invasive method of investigation.

Correspondence should be addressed to Dr Carlos Wigderowitz, Honorary Secretary of BORS, Division of Surgery & Oncology, Section of Orthopaedic & Trauma Surgery, Ninewells Hospital & Medical School Tort Centre, Dundee, DD1 9SY.