Mobile application for quantification of the pivot shift examination: intraoperative usability and utility during real-world deployment
| Autor: | Neel Patel, Richard E. Debski, Conor I Murphy, Robert Tisherman, Volker Musahl |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
030222 orthopedics
medicine.medical_specialty business.industry Anterior cruciate ligament Usability 030229 sport sciences Pivot-shift test Evidence-based medicine Meniscus (anatomy) 03 medical and health sciences 0302 clinical medicine Physical medicine and rehabilitation medicine.anatomical_structure Software deployment Orthopedic surgery medicine Eye tracking Orthopedics and Sports Medicine Surgery business |
| Zdroj: | Journal of ISAKOS. 5:345-350 |
| ISSN: | 2059-7754 |
| Popis: | Objective The objective of the current study was to evaluate the utility and ease of use of a novel non-invasive tablet-based application for quantification of the pivot shift (QPS) in a multicentre setting. Methods Nine senior orthopaedic surgeons were recruited from academic medical centres and enrolled a total of 90 subjects. All surgeons received video and electronic training on how to perform QPS measurement using a novel tablet-based visual tracking system. Skin markers were used for visual tracking. Each orthopaedic surgeon performed a pivot shift test and obtained a QPS measurement for 10 subjects with known anterior cruciate ligament (ACL) injuries. Anterior translation of the lateral tibial compartment during the reduction event (in millimetre) was recorded. After all subjects were evaluated, the surgeons completed a survey about the ease of use, utility and willingness to use the mobile-based application in clinical practice. All automated visual tracking used to calculate anterior translation of the lateral tibial compartment was manually evaluated to ensure accurate tracking of skin markers. Statistical comparison was made between groups using Student's t-test with significance defined as p Results The results showed that there is adequate tracking of skin markers to provide a QPS measurement across multiple academic medical centres and surgeons in only 70% of subjects. In 27 of 90 subjects, there were tracking errors which resulted in an invalid QPS measurement. Tracking errors were due to background noise, including objects in the room which were the same colour as the skin markers or use of skin preparation solution similar in colour to the skin markers. The QPS measurement was 3.2±1.8 mm, 2.4±1.3 mm in isolated ACL deficiency, and 3.2±2.0 mm with combined ACL and meniscus injury (not significant). There was significant variation among the QPS measurements of different surgeons (p=0.008). Conclusion This study showed that mobile-based QPS measurement software can be used intraoperatively to allow surgeons greater objective feedback regarding the rotatory laxity of the knee prior to and following ACL reconstruction. Software upgrades with improved real-time feedback could help prevent errors in measurement and improve utility of QPS for assessment of injury severity in subjects. Level of evidence Level III. |
| Databáze: | OpenAIRE |
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