There were no false positives or true negatives. There were no false positives or true negatives.ĪD test carried out in the outpatient setting correctly identified ACL injury in 25 of the 28 patients and in three patients it failed to detect ACL injury. The Lachman test carried out in the outpatient setting correctly identified ACL injury in 22 of the 28 patients and in six patients, it failed to detect ACL injury. Mode of injury was sports related in 14 (50%), road traffic accident in eight (28.5%), and others in six (21.5%). The right knee was affected in 17 (60.7%) patients and the left knee was affected in 11 (39.3%). This study included 28 male patients with ACL injury, the mean age being 26.2 years (range 17–35 years). The findings were entered in a standard proforma and the Lachman test, AD sign, pivot shift test, and McMurray tests were graded as positive or negative and retrieved at the time of the study. The above criteria were utilized to select patients for arthroscopy.
#MCMURRAY MENISCUS TEST SENSITIVITY SERIES#
The indications for arthroscopy in our series were positive ACL laxity, positive McMurray test, giving way symptom, persisting pain, and persisting swelling. MRI of the knee was performed in patients who could afford the investigation. These tests were performed by the same individual in the OPD and the operating theatre, who was not the operating surgeon. The patients included in the study were examined pre-operatively in the outpatient department (OPD) and the ligament laxity was re-examined on the operating table under anesthesia. All the patients in the study subsequently underwent ACL reconstruction using bone patellar tendon bone graft as they did not respond to physiotherapy regime. All the subjects in our study had non-acute ACL injuries where more than 3 weeks had elapsed from the time of injury. Skeletally immature patients with ACL injury were excluded from the study. The diagnosis was made from a combination of history and clinical examination. Presentation was instability alone in eight (28.5%), pain alone in one (3.6%), instability and pain in 15 (53.6%), and instability, pain and swelling in four (14.2%). The mode of injury was sports related in 14 (50%), road traffic accident in eight (28.5%), and others in six (21.5%). Twenty-eight consecutive male patients with ACL injury of the knee with or without other associated ligament injuries of the knee were included in the study. The ethical clearance to conduct the study was obtained from the institutional review board. In this study, we also aim to compare the diagnostic accuracy of the McMurray test for medial and lateral meniscus performed in an outpatient setting with arthroscopy findings. This study was undertaken to calculate the sensitivity, specificity, positive predictive value, negative predictive value, and efficiency for the above-mentioned diagnostic tests.
We aim to compare the diagnostic accuracy of AD sign, Lachman test, and the pivot shift test performed in the outpatient setting and under anesthesia with arthroscopy findings. The sensitivity and specificity of the tests used to diagnose ACL and meniscus injury range from 2 to 100%. Various authors have compared clinical tests with magnetic resonance imaging (MRI) and/or arthroscopy and the non-uniform nature in the accuracy is evident. Generally, it is accepted that the pivot shift test is the most specific test to diagnose ACL tears and that the Lachman test is more sensitive than AD sign. There is no uniformity in the results published about the accuracy of these tests.
Anterior drawer (AD) sign, Lachman test, and pivot shift test are commonly used to diagnose ACL injury. 3 The McMurray test is the most common clinical test used to diagnose meniscal tears.
2, 3 A thorough physical examination is the first step in evaluating a patient with knee pain. Using these tests, the ability to diagnose meniscal and ACL injuries reveals much disparity in accuracy. 1 Several clinical tests have been described to clinically diagnose meniscal and anterior cruciate ligament (ACL) injuries. In addition to taking a clinical history and physical examination, prompt assessment of the extent of knee damage may require further investigation. The purpose of clinical examination is to make a correct diagnosis.
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