Correlation between the rotational degree of the dial test and arthroscopic and physical findings in posterolateral rotatory instability.
Diagnosing posterolateral rotatory instability (PLRI) is difficult because it occurs rarely, takes time to manifest, and no single definitive tool exists in diagnosing posterolateral corner injuries. We sought to evaluate the correlation between rotational degrees in the dial test and physical and arthroscopic findings that surgically verified PLRI in the knee joint. Patients (n = 67) who were diagnosed as having PLRI and received posterolateral reconstruction (n = 57) and repair (n = 10) from 1998 to 2006 were recruited. Preoperative physical findings were evaluated under anesthesia, and arthroscopic findings during surgeries were analyzed. A dial test with post-anesthesia (spinal or general) was conducted. We divided patients into three subgroups (A: <15 degrees, B: 15-20 degrees, and C: >20 degrees), according to differences in rotational degrees in the dial test. All tests showed significant differences among the three groups and positive findings increased as the rotational degrees increased. No test showed a statistically significant difference in the specific group. All tests except for popliteal hiatus widening showed significant differences among the three groups and positive findings also increased as the rotational degrees increased. The total incidence and positive rate of each physical examination and the popliteal hiatus arthroscopic findings in PLRI significantly increased as the rotational degree in the dial test increased. The number of positive findings on physical examination was larger than the number of positive findings by arthroscopy in all three groups.
Kim
Jin Goo
JG
Department of Orthopedics, Inje University Seoul Paik Hospital, Seoul, Korea.
Lee
Yong Seuk
YS
Kim
Young Jae
YJ
Shim
Jae Chan
JC
Ha
Jeong Ku
JK
Park
Hyun Ah
HA
Yang
Sang Jin
SJ
Oh
Soo Jin
SJ
D000293:Adolescent; D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis*; D007719:Knee Joint / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D016119:Posterior Cruciate Ligament / Q000293:injuries; D016059:Range of Motion, Articular; D012399:Rotation; D013708:Tendon Injuries / Q000175:diagnosis*; D000070600:Tibial Meniscus Injuries; D055815:Young Adult