The Journal of Korean Physical Therapy

The Korean Society of Physical Therapy (대한물리치료학회)
권호 표지
DOI QR코드

DOI QR Code

Diagnostic Accuracy of Clinical Test for Anterior Cruciate Ligament Injury: Systematic Review

  • Deniz Yasemin (Department of Physical Therapy, College of Health Science, SunMoon University) ;
  • Sang-Woo Pyun (Department of Physical Therapy, College of Health Science, SunMoon University) ;
  • HyungSu Lee (Department of Physical Therapy, College of Health Science, SunMoon University) ;
  • Seong-Eun Kim (Department of Physical Therapy, College of Health Science, SunMoon University) ;
  • SunGyu Han (Department of Physical Therapy, College of Health Science, SunMoon University) ;
  • Dongyeop Lee (Department of Physical Therapy, College of Health Science, SunMoon University) ;
  • Ji-Heon Hong (Department of Physical Therapy, College of Health Science, SunMoon University) ;
  • Jae-Ho Yu (Department of Physical Therapy, College of Health Science, SunMoon University) ;
  • Jin-Seop Kim (Department of Physical Therapy, College of Health Science, SunMoon University) ;
  • Seong-gil Kim (Department of Physical Therapy, College of Health Science, SunMoon University)
  • Received : 2023.05.15
  • Accepted : 2023.06.19
  • Published : 2023.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The aim of this study was to conduct a systematic review of randomized controlled studies from 2012 to present that explore the diagnostic accuracy of clinical tests used for diagnosing anterior cruciate ligament (ACL) injury. Methods: Study design: Systematic review. Literature search of the PubMed and Scholar databases was conducted using keywords related to diagnostic accuracy of clinical tests for ACL injury. The PRISMA Guidelines were followed to conduct this study. The Cochrane Risk of Bias Tool was utilized to assess the quality of each included study. Results: As a result, 8 studies were included, and 6 clinical tests used in ACL tears were evaluated for diagnostic accuracy. The pivot shift test was reported as having the highest +LR (29.5) value with a sensitivity of 59% and a specificity of 98%. However, the test with the lowest -LR value was the lever test, and the values were as follows: -LR (0.08), +LR (4.7), specificity (80%), sensitivity (94%). Conclusion: In this study, it was concluded that a single clinical test is not sufficient to determine the presence of ACL injury. Test combinations have a higher diagnostic accuracy than a single test. In this study, the accuracy of the clinical tests was examined without considering the amount of ACL rupture and acute-chronic condition. Further research is required to examine the impact of these two factors on diagnostic accuracy of clinical test.

Keywords

References

  1. Petersen W, Tillmann B. Anatomy and function of the anterior cruciate ligament. Orthopade. 2002;31(8):710-8. https://doi.org/10.1007/s00132-002-0330-0
  2. Won LH. Evidence-based physical therapy for anterior cruciate ligament injury: literature review. J Kor Phys Ther. 2019;31(4):161-8. https://doi.org/10.18857/jkpt.2019.31.4.161
  3. Evans J, Nielson JL. Anterior cruciate ligament knee injuries. Treasure Island (FL). StatPearls Publishing. 2018.
  4. Butler DL, Noyes FR, Grood ES. Ligamentous restraints to anterior-posterior drawer in the human knee. J Bone Joint Surg Am. 1980;62(2):259-70. https://doi.org/10.2106/00004623-198062020-00013
  5. Kwon HJ, Park DS, Jeong JR et al. The effect of silicone sleeve and taping on balance and strength in anterior cruciate ligament reconstruction patients. J Kor Phys Ther. 2014;26(3):147-55.
  6. Kwon SB, Lee HO. Effect of closed and open kinetic chain exercise after cruciate ligament reconstruction. J Kor Phys Ther. 2014;26(3):223-31.
  7. Hyun SW, Kim SH, Kim TH. Comparing changes in knee muscle strength after reconstruction of the anterior and posterior cruciate ligaments. J Kor Phys Ther. 2019;31(6):339-45. https://doi.org/10.18857/jkpt.2019.31.6.339
  8. Damgaci K. The lesions in association with acl rupture and timing of surgery. Adnan Menderes University. Dissertation of Doctorate Degree. 2006.
  9. Moses B, Orchard J, Orchard J. Systematic review: annual incidence of ACL injury and surgery in various populations. Res Sports Med. 2012;20(3-4):157-79. https://doi.org/10.1080/15438627.2012.680633
  10. Abruscato K, Browning K, Deleandro D et al. Diagnostic accuracy of the lever sign in detecting anterior cruciate ligament tears: a systematic review and meta-analysis. Int J Sports Phys Ther. 2019;14(1):2-13. https://doi.org/10.26603/ijspt20190002
  11. Swain MS, Henschke N, Kamper SJ et al. Accuracy of clinical tests in the diagnosis of anterior cruciate ligament injury: a systematic review. Chiropr Man Therap. 2014;22(1):1-10. https://doi.org/10.1186/2045-709X-22-1
  12. Zhao M, Zhou Y, Chang J et al. The accuracy of MRI in the diagnosis of anterior cruciate ligament injury. Ann Transl Med. 2020;8(24):1657.
  13. Lichtenberg MC, Koster CH, Teunissen LPJ et al. Does the lever sign test have added value for diagnosing anterior cruciate ligament ruptures? Orthop J Sports Med. 2018;6(3):2325967118759631.
  14. Hayden SR, Brown MD. Likelihood ratio: a powerful tool for incorporating the results of a diagnostic test into clinical decision making. Ann Emerg Med.1999;33(5):575-80.
  15. Dessaur WA, Magarey ME. Diagnostic accuracy of clinical tests for superior labral anterior posterior lesions: a systematic review. J Orthop Sports Phys Ther. 2008;38(6):341-52. https://doi.org/10.2519/jospt.2008.38.6.341
  16. Decary S, Fallaha M, Belzile S et al. Clinical diagnosis of partial or complete anterior cruciate ligament tears using patients' history elements and physical examination tests. PloS One. 2018;13(6):e0198797.
  17. Gurpinar T, Polat B, Polat AE et al. Diagnostic accuracy of lever sign test in acute, chronic, and postreconstructive ACL injuries. Biomed Res Int. 2019;2019:3639693.
  18. Blanke F, Haenle M, Feitenhansl A et al. The forced active buckling sign: a New Clinical Test for the Diagnosis of ACL Insufficiency. J Knee Surg. 2020;33(1):42-7. https://doi.org/10.1055/s-0038-1676351
  19. Jarbo KA, Hartigan DE, Scott KL et al. Accuracy of the lever sign test in the diagnosis of anterior cruciate ligament injuries. Orthop J Sports Med. 2017;5(10):2325967117729809.
  20. Massey PA, Harris JD, Winston LA et al. Critical analysis of the lever test for diagnosis of anterior cruciate ligament insufficiency. Arthroscopy. 2017;33(8):1560-6. https://doi.org/10.1016/j.arthro.2017.03.007
  21. Zhao GL, Lyu JY, Liu CQ et al. A modified anterior drawer test for anterior cruciate ligament ruptures. J Orthop Surg Res. 2021;16(1):260.
  22. Mulligan EP, Anderson A, Watson S et al. The diagnostic accuracy of the lever sign for detecting anterior cruciate ligament injury. Int J Sports Phys Ther. 2017;12(7):1057-67. https://doi.org/10.26603/ijspt20171057
  23. Armijo-Olivo S, Saltaji H, da Costa BR et al. What is the influence of randomisation sequence generation and allocation concealment on treatment effects of physical therapy trials? A Meta-Epidemiological Study. BMJ Open. 2015;5(9):e008562.
  24. Huang W, Zhang Y, Yao Z, Ma L. Clinical examination of anterior cruciate ligament rupture: a systematic review and meta-analysis. Acta Orthop Traumatol Turc. 2016;50(1):22-31.
  25. Sokal PA, Norris R, Maddox TW, Oldershaw RA. The diagnostic accuracy of clinical tests for anterior cruciate ligament tears are comparable but the Lachman test has been previously overestimated: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2022;30(10):3287-303. https://doi.org/10.1007/s00167-022-06898-4
  26. Tanaka S, Inoue Y, Masuda Y et al. Diagnostic accuracy of physical examination tests for suspected acute anterior cruciate ligament injury: a systematic review and meta-analysis. Int J Sports Phys Ther. 2022;17(5):742-52. https://doi.org/10.26603/001c.36434
  27. Huang Z, Liu Z, Fan C et al. Value of clinical tests in diagnosing anterior cruciate ligament injuries: a systematic review and meta-analysis. Medicine (Baltimore). 2022;101(31):e29263.
  28. Marill KA, Chang Y, Wong KF et al. Estimating negative likelihood ratio confidence when test sensitivity is 100%: a bootstrapping Approach. Stat Methods Med Res. 2017;26(4):1936-48. https://doi.org/10.1177/0962280215592907
  29. Kim IS, Lim WS, Vae SS. The effects of functional movement recovery of physical therapy after ACL reconstruction with MCL injury. J Kor Phys Ther. 2002;14(1):27-37.