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A novel test for assessment of anterolateral rotatory instability of the knee: the tibial internal rotation test (TIR test)

Overview of attention for article published in Journal of Experimental Orthopaedics, August 2018
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  • Above-average Attention Score compared to outputs of the same age (56th percentile)

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27 Mendeley
Title
A novel test for assessment of anterolateral rotatory instability of the knee: the tibial internal rotation test (TIR test)
Published in
Journal of Experimental Orthopaedics, August 2018
DOI 10.1186/s40634-018-0141-9
Pubmed ID
Authors

Malou E. Slichter, Nienke Wolterbeek, K. Gie Auw Yang, Jacco A. C. Zijl, Tom M. Piscaer

Abstract

Rotational instability of the knee may persist after anterior cruciate ligament (ACL) reconstruction, which may be due to insufficiency of anterolateral stabilizing structures. However, no reliable diagnostic tool or physical examination test is available for identifying patients with anterolateral rotatory instability (ALRI). As shown in cadaveric studies, static internal rotation of the knee is increased in higher flexion angles of the knee after severing the anterolateral structures. This might also be the case in patients with an ACL-deficient knee and concomitant damage to the anterolateral structures. The objective of this study is to assess anterolateral rotatory instability of the knee during physical examination with a tibial internal rotation test. ACL-injured knees of 52 patients were examined by two examiners and side-to-side differences were compared. Both lower legs were internally rotated by applying manual internal rotation torque to both feet in prone position with the knees in 30°, 60° and 90° of flexion. For quantification of the amount of rotation in degrees, a torque adapter on a booth was used. Intra-rater, inter-rater and rater-device agreement were determined by calculating kappa (κ) for the tibial internal rotation test. Tibial internal rotation is increased in 19.2% of the patients with ACL injury according to the tibial internal rotation test. Good intra-rater agreement was found for the tibial internal rotation test, κC = 0.63 (95%CI -0.02-1.28), p = 0.015. Fair inter-rater agreement was found, κF = 0.29 (95%CI 0.02-0.57), p = 0.038. Good rater-device agreement was found, κC = 0.62 (95%CI 0.15-1.10), p = 0.001. The tibial internal rotation test shows increased tibial internal rotation in a small amount of patients with ACL injury. Even though no gold standard for assessment of increased tibial internal rotation of the knee is available yet, the test can be of additional value. It can be used for assessment of internal rotatory laxity of the knee as part of ALRI in addition to the pivot shift test. No clinical implications should yet be based on this test alone.

Twitter Demographics

The data shown below were collected from the profiles of 5 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 27 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 27 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 5 19%
Student > Master 5 19%
Student > Bachelor 5 19%
Other 2 7%
Librarian 2 7%
Other 0 0%
Unknown 8 30%
Readers by discipline Count As %
Medicine and Dentistry 8 30%
Nursing and Health Professions 3 11%
Sports and Recreations 3 11%
Agricultural and Biological Sciences 2 7%
Computer Science 1 4%
Other 1 4%
Unknown 9 33%

Attention Score in Context

This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 20 August 2018.
All research outputs
#7,121,184
of 13,804,624 outputs
Outputs from Journal of Experimental Orthopaedics
#27
of 84 outputs
Outputs of similar age
#114,041
of 270,475 outputs
Outputs of similar age from Journal of Experimental Orthopaedics
#1
of 1 outputs
Altmetric has tracked 13,804,624 research outputs across all sources so far. This one is in the 47th percentile – i.e., 47% of other outputs scored the same or lower than it.
So far Altmetric has tracked 84 research outputs from this source. They receive a mean Attention Score of 4.2. This one has gotten more attention than average, scoring higher than 67% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 270,475 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 56% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them