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


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2015-03-13

AUTHORS

Marie-Claude Leblanc, Marcin Kowalczuk, Nicole Andruszkiewicz, Nicole Simunovic, Forough Farrokhyar, Travis Lee Turnbull, Richard E. Debski, Olufemi R. Ayeni

ABSTRACT

Purpose 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.MethodsSearching 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.ResultsEight 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.ConclusionDecreased sensitivity of Lachman and pivot shift tests for partial rupture cases and for awake patients raised suspicions regarding the accuracy of these tests for diagnosis of ACL insufficiency. This may lead to further research aiming to improve the understanding of the true accuracy of these physical diagnostic tests and increase the reliability of clinical investigation for this pathology.Level of evidenceIV. More... »

PAGES

2805-2813

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00167-015-3563-2

DOI

http://dx.doi.org/10.1007/s00167-015-3563-2

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1051268578

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/25763847


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