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

Verfasser / Beitragende:
[Marie-Claude Leblanc, Marcin Kowalczuk, Nicole Andruszkiewicz, Nicole Simunovic, Forough Farrokhyar, Travis Turnbull, Richard Debski, Olufemi Ayeni]
Ort, Verlag, Jahr:
2015
Enthalten in:
Knee Surgery, Sports Traumatology, Arthroscopy, 23/10(2015-10-01), 2805-2813
Format:
Artikel (online)
ID: 605458405
LEADER caa a22 4500
001 605458405
003 CHVBK
005 20210128100228.0
007 cr unu---uuuuu
008 210128e20151001xx s 000 0 eng
024 7 0 |a 10.1007/s00167-015-3563-2  |2 doi 
035 |a (NATIONALLICENCE)springer-10.1007/s00167-015-3563-2 
245 0 0 |a Diagnostic accuracy of physical examination for anterior knee instability: a systematic review  |h [Elektronische Daten]  |c [Marie-Claude Leblanc, Marcin Kowalczuk, Nicole Andruszkiewicz, Nicole Simunovic, Forough Farrokhyar, Travis Turnbull, Richard Debski, Olufemi Ayeni] 
520 3 |a 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. Methods: 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. Results: 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. Conclusion: Decreased 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 evidence: IV. 
540 |a European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA), 2015 
690 7 |a Anterior cruciate ligament  |2 nationallicence 
690 7 |a Rupture  |2 nationallicence 
690 7 |a Diagnostic accuracy  |2 nationallicence 
690 7 |a Physical examination  |2 nationallicence 
690 7 |a Knee injuries  |2 nationallicence 
700 1 |a Leblanc  |D Marie-Claude  |u Division of Orthopedic Surgery, Department of Surgery, McMaster University, 4E15- 1200 Main St W, L8N 3Z5, Hamilton, ON, Canada  |4 aut 
700 1 |a Kowalczuk  |D Marcin  |u Division of Orthopedic Surgery, Department of Surgery, McMaster University, 4E15- 1200 Main St W, L8N 3Z5, Hamilton, ON, Canada  |4 aut 
700 1 |a Andruszkiewicz  |D Nicole  |u Department of Public Health Sciences, Queen's University, Kingston, ON, Canada  |4 aut 
700 1 |a Simunovic  |D Nicole  |u Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada  |4 aut 
700 1 |a Farrokhyar  |D Forough  |u Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada  |4 aut 
700 1 |a Turnbull  |D Travis  |u Department of BioMedical Engineering, Steadman Philippon Research Institute, Vail, CO, USA  |4 aut 
700 1 |a Debski  |D Richard  |u Orthopaedic Robotics Laboratory, University of Pittsburgh, Pittsburgh, PA, USA  |4 aut 
700 1 |a Ayeni  |D Olufemi  |u Division of Orthopedic Surgery, Department of Surgery, McMaster University, 4E15- 1200 Main St W, L8N 3Z5, Hamilton, ON, Canada  |4 aut 
773 0 |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/10(2015-10-01), 2805-2813  |x 0942-2056  |q 23:10<2805  |1 2015  |2 23  |o 167 
856 4 0 |u https://doi.org/10.1007/s00167-015-3563-2  |q text/html  |z Onlinezugriff via DOI 
898 |a BK010053  |b XK010053  |c XK010000 
900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
908 |D 1  |a review-article  |2 jats 
949 |B NATIONALLICENCE  |F NATIONALLICENCE  |b NL-springer 
950 |B NATIONALLICENCE  |P 856  |E 40  |u https://doi.org/10.1007/s00167-015-3563-2  |q text/html  |z Onlinezugriff via DOI 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Leblanc  |D Marie-Claude  |u Division of Orthopedic Surgery, Department of Surgery, McMaster University, 4E15- 1200 Main St W, L8N 3Z5, Hamilton, ON, Canada  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Kowalczuk  |D Marcin  |u Division of Orthopedic Surgery, Department of Surgery, McMaster University, 4E15- 1200 Main St W, L8N 3Z5, Hamilton, ON, Canada  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Andruszkiewicz  |D Nicole  |u Department of Public Health Sciences, Queen's University, Kingston, ON, Canada  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Simunovic  |D Nicole  |u Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Farrokhyar  |D Forough  |u Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Turnbull  |D Travis  |u Department of BioMedical Engineering, Steadman Philippon Research Institute, Vail, CO, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Debski  |D Richard  |u Orthopaedic Robotics Laboratory, University of Pittsburgh, Pittsburgh, PA, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Ayeni  |D Olufemi  |u Division of Orthopedic Surgery, Department of Surgery, McMaster University, 4E15- 1200 Main St W, L8N 3Z5, Hamilton, ON, Canada  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/10(2015-10-01), 2805-2813  |x 0942-2056  |q 23:10<2805  |1 2015  |2 23  |o 167