caa a22 4500 605458405 CHVBK 20210128100228.0 cr unu---uuuuu 210128e20151001xx s 000 0 eng 10.1007/s00167-015-3563-2 doi (NATIONALLICENCE)springer-10.1007/s00167-015-3563-2 Diagnostic accuracy of physical examination for anterior knee instability: a systematic review [Elektronische Daten] [Marie-Claude Leblanc, Marcin Kowalczuk, Nicole Andruszkiewicz, Nicole Simunovic, Forough Farrokhyar, Travis Turnbull, Richard Debski, Olufemi Ayeni] 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. European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA), 2015 Anterior cruciate ligament nationallicence Rupture nationallicence Diagnostic accuracy nationallicence Physical examination nationallicence Knee injuries nationallicence Leblanc Marie-Claude Division of Orthopedic Surgery, Department of Surgery, McMaster University, 4E15- 1200 Main St W, L8N 3Z5, Hamilton, ON, Canada aut Kowalczuk Marcin Division of Orthopedic Surgery, Department of Surgery, McMaster University, 4E15- 1200 Main St W, L8N 3Z5, Hamilton, ON, Canada aut Andruszkiewicz Nicole Department of Public Health Sciences, Queen's University, Kingston, ON, Canada aut Simunovic Nicole Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada aut Farrokhyar Forough Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada aut Turnbull Travis Department of BioMedical Engineering, Steadman Philippon Research Institute, Vail, CO, USA aut Debski Richard Orthopaedic Robotics Laboratory, University of Pittsburgh, Pittsburgh, PA, USA aut Ayeni Olufemi Division of Orthopedic Surgery, Department of Surgery, McMaster University, 4E15- 1200 Main St W, L8N 3Z5, Hamilton, ON, Canada aut Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/10(2015-10-01), 2805-2813 0942-2056 23:10<2805 2015 23 167 https://doi.org/10.1007/s00167-015-3563-2 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 review-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00167-015-3563-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Leblanc Marie-Claude Division of Orthopedic Surgery, Department of Surgery, McMaster University, 4E15- 1200 Main St W, L8N 3Z5, Hamilton, ON, Canada aut NATIONALLICENCE 700 1- Kowalczuk Marcin Division of Orthopedic Surgery, Department of Surgery, McMaster University, 4E15- 1200 Main St W, L8N 3Z5, Hamilton, ON, Canada aut NATIONALLICENCE 700 1- Andruszkiewicz Nicole Department of Public Health Sciences, Queen's University, Kingston, ON, Canada aut NATIONALLICENCE 700 1- Simunovic Nicole Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada aut NATIONALLICENCE 700 1- Farrokhyar Forough Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada aut NATIONALLICENCE 700 1- Turnbull Travis Department of BioMedical Engineering, Steadman Philippon Research Institute, Vail, CO, USA aut NATIONALLICENCE 700 1- Debski Richard Orthopaedic Robotics Laboratory, University of Pittsburgh, Pittsburgh, PA, USA aut NATIONALLICENCE 700 1- Ayeni Olufemi Division of Orthopedic Surgery, Department of Surgery, McMaster University, 4E15- 1200 Main St W, L8N 3Z5, Hamilton, ON, Canada aut NATIONALLICENCE 773 0- Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/10(2015-10-01), 2805-2813 0942-2056 23:10<2805 2015 23 167