J Korean Phys Ther.  2023 Jun;35(3):57-63. 10.18857/jkpt.2023.35.3.57.

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

• Yasemin D
• Pyun SW
• Lee H
• Kim SE
• Han S
• Lee D
• Hong JH
• Yu JH
• Kim JS
• Kim Sg

• KMID: 2552703
• DOI: http://doi.org/10.18857/jkpt.2023.35.3.57

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.

Keyword

Anterior cruciate ligament injury; Diagnostic test accuracy; Sensitivity; Lachman; Anterior drawer test