The diagnostic accuracy of ruptures of the anterior cruciate ligament comparing the Lachman test, the anterior drawer sign, and the pivot shift test in acute and chronic knee injuries
| Autor: | Jerald W. Katz, Richard J. Fingeroth |
|---|---|
| Rok vydání: | 1986 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent Anterior cruciate ligament Physical Therapy Sports Therapy and Rehabilitation Diagnostic accuracy Knee Injuries Lachman test 03 medical and health sciences 0302 clinical medicine medicine Humans Orthopedics and Sports Medicine Physical Examination Anterior drawer Retrospective Studies Rupture 030222 orthopedics medicine.diagnostic_test business.industry Arthroscopy 030229 sport sciences Pivot-shift test Middle Aged Surgery medicine.anatomical_structure Acute Disease Athletic Injuries Chronic Disease Ligaments Articular business Knee injuries Sign (mathematics) |
| Zdroj: | The American Journal of Sports Medicine. 14:88-91 |
| ISSN: | 1552-3365 0363-5465 |
| DOI: | 10.1177/036354658601400115 |
| Popis: | Eighty-five patients with knee injuries were included in a 4 month retrospective study that compared the rela tive accuracy of the Lachman test, the anterior drawer sign, and the pivot shift test. All examinations were performed under anesthesia and followed by arthros copy, which confirmed 22 injuries. Of all ACL injuries occurring within 2 weeks of arthroscopy (N = 9), the pivot shift test was the most sensitive (88.8%), followed by the Lachman test with a 77.7% sensitivity. The anterior drawer sign was the least sensitive at 22.2%. All had specificities more than 95%. For all injuries of more than 2 weeks (N = 13), the Lachman and pivot shift tests were 84.6% sensitive, while the anterior drawer sign increased to a sensitivity of 53.8%. Again, all were specific to more than 95%. For all ACL injuries, irrespective of age, the Lachman test was 81.8% sen sitive and 96.8% specific; the anterior drawer sign was 40.9% sensitive and 95.2% specific; and the pivot shift was 81.8% sensitive and 98.4% specific. The data support an accurate preoperative diagnosis in ACL deficient knees when the Lachman and pivot shift tests are positive, and essentially rules out this type of injury when these tests are negative. The anterior drawer sign, although widely used, is a poor diagnostic indi cator of ACL injuries, especially in the acute setting. |
| Databáze: | OpenAIRE |
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