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Sonographic evaluation of the degree of medial meniscal extrusion during Thessaly test in healthy knees

OBJECTIVE: The Thessaly test is a commonly used orthopedic test for meniscus tear evaluation. The study’s objective is to evaluate the degree of medial meniscal extrusion during different loading phases of the Thessaly test. METHODS: A convenience sample of 60 healthy knees (35 participants) was exa...

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Autores principales: Cho, John C., Tollefson, Lauren, Reckelhoff, Kenneth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8369788/
https://www.ncbi.nlm.nih.gov/pubmed/34404437
http://dx.doi.org/10.1186/s12998-021-00390-5
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author Cho, John C.
Tollefson, Lauren
Reckelhoff, Kenneth
author_facet Cho, John C.
Tollefson, Lauren
Reckelhoff, Kenneth
author_sort Cho, John C.
collection PubMed
description OBJECTIVE: The Thessaly test is a commonly used orthopedic test for meniscus tear evaluation. The study’s objective is to evaluate the degree of medial meniscal extrusion during different loading phases of the Thessaly test. METHODS: A convenience sample of 60 healthy knees (35 participants) was examined and the data sets were collected from October 8, 2018 through February 8, 2019. Sonographic measurement of the degree of physiologic extrusion of the medial meniscus deep to the medial collateral ligament was taken by two examiners at six different loading phases: supine, standing, 5° knee-flexion with internal (IR)/external (ER) rotation and 20° knee-flexion with IR/ER. The difference in meniscal extrusion by knee position was compared with ANOVA. Interexaminer reproducibility assessment was analyzed using limits of agreement. RESULTS: The mean meniscal extrusion for each position was—supine: 2.3 ± 0.5 mm, standing: 2.8 ± 0.8 mm, 5° IR: 2.3 ± 0.9 mm, 5° ER: 2.4 ± 0.7 mm, 20° IR: 1.9 ± 0.8 mm, and 20° ER: 2.3 ± 0.7 mm. Significant increase in extrusion was observed from supine to standing (p < 0.05) and from 20° IR to 20° ER (p = 0.015). Significant decreased measurement was observed from standing to 5° IR (p < 0.05), 5° ER (p < 0.05), 20° IR (p < 0.05) and 20° ER (p < 0.05). There is no significant change between 5° IR and 5° ER (p = 1.0). Agreement parameters revealed that the differences between examiner measurements were minimal; 75% of both examiners’ meniscal extrusion measurements were within 1.0 mm with 97% of measurements falling within 2.0 mm. CONCLUSION: Our study’s novel findings showed various degrees of physiological extrusion of the medial meniscus in asymptomatic knees during the loading phases involved in the Thessaly test. Physiological MME does exist and should not be defaulted to pathologic meniscus as previously described. Agreement parameters suggest that measurement of meniscal extrusion during the Thessaly test is reproducible between different examiners.
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spelling pubmed-83697882021-08-18 Sonographic evaluation of the degree of medial meniscal extrusion during Thessaly test in healthy knees Cho, John C. Tollefson, Lauren Reckelhoff, Kenneth Chiropr Man Therap Research OBJECTIVE: The Thessaly test is a commonly used orthopedic test for meniscus tear evaluation. The study’s objective is to evaluate the degree of medial meniscal extrusion during different loading phases of the Thessaly test. METHODS: A convenience sample of 60 healthy knees (35 participants) was examined and the data sets were collected from October 8, 2018 through February 8, 2019. Sonographic measurement of the degree of physiologic extrusion of the medial meniscus deep to the medial collateral ligament was taken by two examiners at six different loading phases: supine, standing, 5° knee-flexion with internal (IR)/external (ER) rotation and 20° knee-flexion with IR/ER. The difference in meniscal extrusion by knee position was compared with ANOVA. Interexaminer reproducibility assessment was analyzed using limits of agreement. RESULTS: The mean meniscal extrusion for each position was—supine: 2.3 ± 0.5 mm, standing: 2.8 ± 0.8 mm, 5° IR: 2.3 ± 0.9 mm, 5° ER: 2.4 ± 0.7 mm, 20° IR: 1.9 ± 0.8 mm, and 20° ER: 2.3 ± 0.7 mm. Significant increase in extrusion was observed from supine to standing (p < 0.05) and from 20° IR to 20° ER (p = 0.015). Significant decreased measurement was observed from standing to 5° IR (p < 0.05), 5° ER (p < 0.05), 20° IR (p < 0.05) and 20° ER (p < 0.05). There is no significant change between 5° IR and 5° ER (p = 1.0). Agreement parameters revealed that the differences between examiner measurements were minimal; 75% of both examiners’ meniscal extrusion measurements were within 1.0 mm with 97% of measurements falling within 2.0 mm. CONCLUSION: Our study’s novel findings showed various degrees of physiological extrusion of the medial meniscus in asymptomatic knees during the loading phases involved in the Thessaly test. Physiological MME does exist and should not be defaulted to pathologic meniscus as previously described. Agreement parameters suggest that measurement of meniscal extrusion during the Thessaly test is reproducible between different examiners. BioMed Central 2021-08-17 /pmc/articles/PMC8369788/ /pubmed/34404437 http://dx.doi.org/10.1186/s12998-021-00390-5 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Cho, John C.
Tollefson, Lauren
Reckelhoff, Kenneth
Sonographic evaluation of the degree of medial meniscal extrusion during Thessaly test in healthy knees
title Sonographic evaluation of the degree of medial meniscal extrusion during Thessaly test in healthy knees
title_full Sonographic evaluation of the degree of medial meniscal extrusion during Thessaly test in healthy knees
title_fullStr Sonographic evaluation of the degree of medial meniscal extrusion during Thessaly test in healthy knees
title_full_unstemmed Sonographic evaluation of the degree of medial meniscal extrusion during Thessaly test in healthy knees
title_short Sonographic evaluation of the degree of medial meniscal extrusion during Thessaly test in healthy knees
title_sort sonographic evaluation of the degree of medial meniscal extrusion during thessaly test in healthy knees
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8369788/
https://www.ncbi.nlm.nih.gov/pubmed/34404437
http://dx.doi.org/10.1186/s12998-021-00390-5
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