Importance of observer experience in clinical assessment of ankle and subtalar joint laxity: Validation of a multidirectional 3D opto-electronic motion analysis protocol

IF 2 3区医学 Q2 ORTHOPEDICS Foot and Ankle Surgery Pub Date : 2025-03-23 DOI:10.1016/j.fas.2025.03.002

Pierre-Henri Vermorel , Rodolphe Testa , Thomas Neri , Yann Lelonge , François Lintz , Margot Ronat , Yves Tourne , Rémi Philippot

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Abstract

Background

Role of ankle and subtalar ligaments remains poorly understood due to inconsistent literature. This study validates a protocol for analyzing multidirectional foot and ankle motions and assesses the impact of experience on clinical evaluations of ankle and subtalar instability.

Methods

Five cadaveric feet were tested using a 3D opto-electronic system to measure talus, tibia, and calcaneus motions under varying ligament conditions. Anterior Drawer Test (ADT), varus talar tilt test in neutral flexion (VTTT), and in dorsiflexion (VTTTF) were tested by one experienced and one inexperienced observer. The system measured multidirectional angular rotations.

Results

Intra-observer ICC exceeded 0.97. For ADT, flexion/extension and internal/external rotation correlated significantly with laxity scores for both observers (p < 0.05). For VTTT, varus/valgus correlations were stronger for the experienced observer, VTTTF correlations were significant only for the experienced observer.

Conclusion

3D opto-electronic is reliable for foot and ankle multidirectional motion analysis. Experience improves subtalar instability assessment accuracy.

Level of evidence

Level 5 (cadaveric study).

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观察经验在踝关节和距下关节松弛的临床评估中的重要性：多向三维光电运动分析方案的验证。

背景：由于文献不一致，踝关节和距下韧带的作用仍然知之甚少。本研究验证了一种分析多方向足部和踝关节运动的方案，并评估了经验对踝关节和距下不稳定临床评估的影响。方法：采用三维光电系统测量不同韧带状态下的距骨、胫骨和跟骨运动。前抽屉试验（ADT），中性屈曲（VTTT）和背屈（vttf）的距内翻倾斜试验由一名经验丰富的观察者和一名经验不足的观察者进行。该系统测量了多向角旋转。结果：观察者内ICC大于0.97。对于ADT，屈/伸和内/外旋转与两名观察者的松弛评分显著相关（p ）结论：3D光电对足部和踝关节多向运动分析是可靠的。经验提高距下不稳定性评估的准确性。证据等级：5级（尸体研究）。

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来源期刊

Foot and Ankle Surgery ORTHOPEDICS-

CiteScore

4.60

自引率

16.00%

发文量

202

期刊介绍： Foot and Ankle Surgery is essential reading for everyone interested in the foot and ankle and its disorders. The approach is broad and includes all aspects of the subject from basic science to clinical management. Problems of both children and adults are included, as is trauma and chronic disease. Foot and Ankle Surgery is the official journal of European Foot and Ankle Society. The aims of this journal are to promote the art and science of ankle and foot surgery, to publish peer-reviewed research articles, to provide regular reviews by acknowledged experts on common problems, and to provide a forum for discussion with letters to the Editors. Reviews of books are also published. Papers are invited for possible publication in Foot and Ankle Surgery on the understanding that the material has not been published elsewhere or accepted for publication in another journal and does not infringe prior copyright.