Diagnostic accuracy of physical examination for anterior knee instability: a systematic review

Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA
Marie-Claude LeblancOlufemi R Ayeni

Abstract

Determining diagnostic accuracy of Lachman, pivot shift and anterior drawer tests versus gold standard diagnosis (magnetic resonance imaging or arthroscopy) for anterior cruciate ligament (ACL) insufficiency cases. Secondarily, evaluating effects of: chronicity, partial rupture, awake versus anaesthetized evaluation. Searching MEDLINE, EMBASE and PubMed identified studies on diagnostic accuracy for ACL insufficiency. Studies identification and data extraction were performed in duplicate. Quality assessment used QUADAS tool, and statistical analyses were completed for pooled sensitivity and specificity. Eight studies were included. Given insufficient data, pooled analysis was only possible for sensitivity on Lachman and pivot shift test. During awake evaluation, sensitivity for the Lachman test was 89 % (95 % CI 0.76, 0.98) for all rupture types, 96 % (95 % CI 0.90, 1.00) for complete ruptures and 68 % (95 % CI 0.25, 0.98) for partial ruptures. For pivot shift in awake evaluation, results were 79 % (95 % CI 0.63, 0.91) for all rupture types, 86 % (95 % CI 0.68, 0.99) for complete ruptures and 67 % (95 % CI 0.47, 0.83) for partial ruptures. Decreased sensitivity of Lachman and pivot shift tests for partial rupture cases and for a...Continue Reading

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Citations

Aug 4, 2015·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Kaori NakamuraTakeshi Muneta
Oct 4, 2016·Physical Therapy in Sport : Official Journal of the Association of Chartered Physiotherapists in Sports Medicine·Simon DécaryFrançois Desmeules
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Jul 5, 2017·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Benedikt SchliemannClemens Kösters
Mar 24, 2018·Orthopaedic Journal of Sports Medicine·Miranda C LichtenbergIrene R Faber
Jul 10, 2019·BioMed Research International·Tahsin GürpınarYusuf Öztürkmen
Jan 12, 2019·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Yong-Beom ParkSeong Hwan Kim
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Jul 2, 2021·Arthroscopy, Sports Medicine, and Rehabilitation·Laurie A HiemstraSarah Kerslake

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