Clinical Examination in the Diagnosis of Anterior Cruciate Ligament Injury: A Blinded, Cross-sectional Evaluation

Abstract

Objective:This study was conducted to compare the effectiveness of clinical tests for anterior cruciate ligament (ACL) injury.Methods:This study prospectively evaluated the effectiveness of the Lachman test, anterior drawer test, and lever test in diagnosing ACL injury in 133 patients with knee pathology. The examiner was blinded to the patient's history, symptoms, and laterality of the pain at the time of examination. One hundred twenty-three patients in the study underwent MRI, and 90 went on to arthroscopy. The performance of the examination maneuvers and MRI was calculated.Results:This study showed notable differences in sensitivity and specificity between the Lachman test and the lever test and in specificity between the anterior drawer test and the lever test. The Lachman test was also found to be more sensitive than the anterior drawer. All ACL tears diagnosed by a composite of the physical examination maneuvers were confirmed by MRI. MRI findings were concordant with arthroscopic findings in all cases.Conclusions:The Lachman test and the anterior draw test demonstrated clinical utility, but the results of the lever test should be interpreted with caution. Clinical examination was found to be highly specific but less sensitive than MRI.

Anterior Cruciate Ligament Tears in Soccer Players

“…23 Additional maneuvers, including the lever test and the modified anterior drawer, have been described but the previously mentioned examinations remain the most common options for clinicians. 24,25 Anteroposterior and lateral knee radiographs are always utilized as initial imaging for a suspected knee injury. With regards to ACL pathology, one may encounter a tibial eminence fracture as a bony equivalent to an ACL tear.…”

“…The pivot shift test was the most specific test with a pooled specificity of 97.5% (95% CI: 0.95-0.99); and the highest positive likelihood ratios of 16.00 (95% CI: 7.34-34.87) 23 . Additional maneuvers, including the lever test and the modified anterior drawer, have been described but the previously mentioned examinations remain the most common options for clinicians 24,25 …”

Improving inceptionV4 model based on fractional-order snow leopard optimization algorithm for diagnosing of ACL tears

“…Kulwin et al 24 examined the comparison of the efficiency of the medical exams for ACL damage. In the present research, 133 patients with knee pathology were evaluated to determine the efficiency of the anterior drawer, Lachman, and lever tests in detecting ACL harm.…”