Anterior Drawer Test of the Knee: Difference between revisions
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== Evidence<br> == | == Evidence<br> == | ||
One source reports sensitivity and specificity as .41-.91 and .86-1.0 respectively, with a -LR of .09-.62 and a +LR of 5.4-8.2.<ref name="Flynn, Cleland and Whitman">Flynn TW, Cleland JA, Whitman JM. Users' guide to the musculoskeletal examination: Fundamentals for the evidence-based clinician. United States: Evidence in Motion; 2008.</ref> However, a recent meta-analysis reports the sensitivity and specificity as .18-.92 and .78-.98 respectively.<ref name="Scholten et al">Scholten PJPM, Opstelten W, van der Plas CG, Bijl D, Deville WLJM and Bouter LM. Accuracy of physical diagnostic tests for assessing ruptures of the anterior cruciate ligament: a meta-analysis. J Fam Pract. 2003;52:689-694.</ref> Scholten et al concluded that based on predictive value statistics, strong conclusions could not be made regarding whether the anterior drawer test was good to rule in or rule out the presence of an ACL tear.<ref name="Scholten et al">Scholten RJPM, Opstelten W, van der Plas CG, Bijl D, Deville WLJM, Bouter LM. Accuracy of physical diagnostic tests for assessing ruptures of the anterior cruciate ligament: a meta-analysis. J Fam Pract. 2003;52:689–694.</ref> Other recent research has identified the anterior drawer test as a more effective test to identify chronic conditions, with a sensitivity and specificity of .92 and .91.<ref name="Bejaminse, Gokeler and van der Schans">Benjaminse A, Gokeler A van der Schans CP. Clinical diagnosis of an anterior cruciate ligament rupture: a meta-analysis. J Orthop Sports Phys Ther. 2006;36(5):267-88.</ref> | One source reports sensitivity and specificity as .41-.91 and .86-1.0 respectively, with a -LR of .09-.62 and a +LR of 5.4-8.2.<ref name="Flynn, Cleland and Whitman">Flynn TW, Cleland JA, Whitman JM. Users' guide to the musculoskeletal examination: Fundamentals for the evidence-based clinician. United States: Evidence in Motion; 2008.</ref> However, a recent meta-analysis reports the sensitivity and specificity as .18-.92 and .78-.98 respectively.<ref name="Scholten et al">Scholten PJPM, Opstelten W, van der Plas CG, Bijl D, Deville WLJM and Bouter LM. Accuracy of physical diagnostic tests for assessing ruptures of the anterior cruciate ligament: a meta-analysis. J Fam Pract. 2003;52:689-694.</ref> Scholten et al concluded that based on predictive value statistics, strong conclusions could not be made regarding whether the anterior drawer test was good to rule in or rule out the presence of an ACL tear.<ref name="Scholten et al">Scholten RJPM, Opstelten W, van der Plas CG, Bijl D, Deville WLJM, Bouter LM. Accuracy of physical diagnostic tests for assessing ruptures of the anterior cruciate ligament: a meta-analysis. J Fam Pract. 2003;52:689–694.</ref> Other recent research has identified the anterior drawer test as a more effective test to identify chronic conditions, with a sensitivity and specificity of .92 and .91.<ref name="Bejaminse, Gokeler and van der Schans">Benjaminse A, Gokeler A van der Schans CP. Clinical diagnosis of an anterior cruciate ligament rupture: a meta-analysis. J Orthop Sports Phys Ther. 2006;36(5):267-88.</ref> | ||
Tests who are more likely to give an accurate result are the [[Pivot_Shift|pivot shift]] or the [[Lachman_Test|Lachman]] <ref>OSTROWSKI JA, Accuracy of 3 diagnostic tests for anterior cruciate ligament tears, Journal of Athletic Training, 2006, 41(1): 120-122</ref> | |||
== Resources == | == Resources == | ||
Revision as of 15:07, 24 April 2011
Original Editor - Kathryn Schwartzkopf-Phifer
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Purpose
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To test the integrity of the anterior cruciate ligament (ACL)
Technique
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The patient is supine and the knee to be tested is flexed to approximately 90 degrees. The examiner then sits on the toes of the tested extremity to help stabilize it. The examiner grasps the proximal lower leg, approximately at the tibial plateau or joint line, and attempts to translate the lower leg anteriorly. The test is considered positive if there is a lack of end feel or excessive anterior translation.[1]
Evidence
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One source reports sensitivity and specificity as .41-.91 and .86-1.0 respectively, with a -LR of .09-.62 and a +LR of 5.4-8.2.[1] However, a recent meta-analysis reports the sensitivity and specificity as .18-.92 and .78-.98 respectively.[3] Scholten et al concluded that based on predictive value statistics, strong conclusions could not be made regarding whether the anterior drawer test was good to rule in or rule out the presence of an ACL tear.[3] Other recent research has identified the anterior drawer test as a more effective test to identify chronic conditions, with a sensitivity and specificity of .92 and .91.[4]
Tests who are more likely to give an accurate result are the pivot shift or the Lachman [5]
Resources[edit | edit source]
add any relevant resources here
Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
References will automatically be added here, see adding references tutorial.
- ↑ 1.0 1.1 Flynn TW, Cleland JA, Whitman JM. Users' guide to the musculoskeletal examination: fundamentals for the evidence-based clinician. United States: Evidence in Motion; 2008. Cite error: Invalid
<ref>tag; name "Flynn, Cleland and Whitman" defined multiple times with different content - ↑ Anterior drawer test - knee. As seen on youtube: http://www.youtube.com/watch?v=yQdBrr3Mmj0
- ↑ 3.0 3.1 Scholten PJPM, Opstelten W, van der Plas CG, Bijl D, Deville WLJM and Bouter LM. Accuracy of physical diagnostic tests for assessing ruptures of the anterior cruciate ligament: a meta-analysis. J Fam Pract. 2003;52:689-694. Cite error: Invalid
<ref>tag; name "Scholten et al" defined multiple times with different content - ↑ Benjaminse A, Gokeler A van der Schans CP. Clinical diagnosis of an anterior cruciate ligament rupture: a meta-analysis. J Orthop Sports Phys Ther. 2006;36(5):267-88.
- ↑ OSTROWSKI JA, Accuracy of 3 diagnostic tests for anterior cruciate ligament tears, Journal of Athletic Training, 2006, 41(1): 120-122
