Reliability of heel-height measurement for documenting knee extension deficits.
BACKGROUND
Heel-height difference has been used to detect subtle knee flexion contractures, but the effects of thigh circumference differences and patient positioning during testing have not been evaluated.


OBJECTIVE
Differences in thigh circumference measurements and whether the patient's patellae are on or off the examination table during heel-height difference measurement will not affect the accuracy of detecting knee flexion contracture.


METHODS
Prospective cohort study.


METHODS
Bilateral knee range of motion, prone heel-height difference with the patellae on and off the table, and thigh circumference at 5 and 15 cm proximal to the proximal pole of the patella were measured by one investigator on 50 consecutive patients who had undergone unilateral anterior cruciate ligament reconstruction.


RESULTS
A high degree of correlation was demonstrated between the heel-height difference and the standard range of motion measurement. Differences in thigh girth and patellar position did not statistically affect the accuracy of the heel-height difference as an indicator of knee flexion contracture.


CONCLUSIONS
Heel-height difference is a valid method of documenting knee flexion contractures. Compared with traditional goniometer assessment, this test is a more meaningful and easier way for detecting subtle knee flexion contractures of less than 10 degrees.
Steadman Hawkins Denver Clinics, Denver and Vail, Colorado. Steadman Hawkins Sports Medicine Foundation, Vail, Colorado 80111, USA.
Theodore F
TF
Schlegel
Martin
M
Boublik
Richard J
RJ
Hawkins
J Richard
JR
Steadman
D000293:Adolescent; D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries; D003286:Contracture / Q000175:diagnosis*; D005260:Female; D006365:Heel / Q000033:anatomy & histology*; D006801:Humans; D007718:Knee Injuries / Q000601:surgery; D007719:Knee Joint; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013848:Thigh / Q000033:anatomy & histology