Critical Analysis of the Lever Test for Diagnosis of Anterior Cruciate Ligament Insufficiency

Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association
Patrick A MasseyPatrick C McCulloch

Abstract

To critically analyze the "lever test" in detecting anterior cruciate ligament (ACL) tears and to compare its accuracy with the Lachman, anterior drawer (AD), and pivot shift tests. From June 2014 to June 2015, 91 subjects were analyzed. Inclusion criteria were subjects aged 16 to 60 years, presenting after a knee injury with subjective swelling, or an objective effusion and an uninjured normal contralateral knee for comparison. Exclusion criteria included previous knee ligamentous reconstruction, fracture of the distal femur or proximal tibia, bilateral knee injuries, or known cruciate ligament tear. The Lachman, AD, pivot shift, and lever tests were performed in the office by 2 board-certified orthopaedic surgeons with patient awake. Examiners were blinded to the presence or absence of ACL injury. Magnetic resonance imaging was used to determine injury. Sensitivity, specificity, and accuracy were evaluated for all 4 tests. Accuracy was compared using χ-square and receiver operator curves. Average subject age was 28 ± 11 years (61 males, 30 females). Seventy-one (79%) had ACL tears diagnosed by magnetic resonance imaging. The sensitivity, specificity, and accuracy of the lever test were 83%, 80%, and 82%, respectively. Accurac...Continue Reading

References

May 20, 2004·The American Journal of Sports Medicine·Odd-Egil OlsenRoald Bahr

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Citations

Jul 10, 2019·BioMed Research International·Tahsin GürpınarYusuf Öztürkmen

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