Comparing the Diagnostic Accuracy of Two Selective Tissue Tests for Anterior Cruciate Ligament Injuries: A Critically Appraised Topic

in International Journal of Athletic Therapy and Training
Rafael Squillantini MSAT, LAT, ATC * , 1 , Brielle Ringle MSAT, LAT, ATC * , 1 and Julie Cavallario PhD, LAT, ATC * , 1
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  • 1 Old Dominion University
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Clinical Question: In patients with acute knee injuries, is there evidence to support that the lever sign test is more accurate in diagnosing an anterior cruciate ligament sprain than the Lachman test? Clinical Bottom Line: The evidence does not indicate that the lever sign test can be used in isolation in lieu of the Lachman test, but there is sufficient evidence to support adding the lever sign test to the examination of potential anterior cruciate ligament sprains.

Squillantini and Ringle are recent graduates from the Post-Professional Athletic Training Program at Old Dominion University, Norfolk, VA. Cavallario is an assistant professor and program director of the athletic training program at Old Dominion University, Norfolk, VA.

Squillantini (rafsquil@gmail.com) is corresponding author.
  • 1.

    Dai B, Herman D, Liu H, Garrett W, Yu B. Prevention of ACL injury, part I: injury characteristics, risk factors, and loading mechanism. Res Sports Med. 2012;20(3/4):180197. doi:10.1080/15438627.2012.680990

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Hewett T, Ford K, Hoogenboom B, Myer G. Understanding and preventing ACL injuries: current biomechanical and epidemiologic considerations update 2010. N Am J Sports Phys Ther. 2010;5(4):234251. PubMed ID: 21655382

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Jarbo KA, Hartigan DE, Scott KL, Patel KA, Chhabra A. Accuracy of the Lever sign test in the diagnosis of anterior cruciate ligament injuries. Orthop J Sports Med. 2017;5(10):2325967117729809. PubMed ID: 29051898 doi:10.1177/2325967117729809

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4.

    Lelli A, Di Turi RP, Spenciner DB, Domini M. The “Lever sign”: a new clinical test for the diagnosis of anterior cruciate ligament rupture. Knee Surg Sports Traumatol Arthrosc. 2016;24:27942797. PubMed ID: 25536951 doi:10.1007/s00167-014-3490-7

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Oxford Centre for Evidence-Based Medicine. Oxford Centre for Evidence-Based Medicine-Levels of Evidence. 2009. http://www.cebm.net/oxford-centre-evidence-based-medicine-levels-evidence-march-2009/. Accessed January 29, 2018.

    • Export Citation
  • 6.

    Maher CG, Sherrington C, Herbert RD, Moseley AM, Elkins M. Reliability of the PEDro scale for rating quality of randomized controlled trials. Phys ther. 2003;83(8):713721. PubMed ID: 12882612

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Thappa SS, Lamichhane AP, Mahara DP. Accuracy of Lelli test for anterior cruciate ligament tear. J Inst Med. 2015;37(2):9194.

  • 8.

    Chong AC, Whitetree C, Priddy MC, Zimmerman PR, Haeder PR, Prohaska DJ. Evaluating different clinical diagnosis of anterior cruciate ligament ruptures in providers with different training backgrounds. Iowa Orthop J. 2016;37:7179.

    • Search Google Scholar
    • Export Citation
  • 9.

    Deveci A, Cankaya D, Yilmaz S, Ozdemir G, Arslantas E, Bozkurt M. The arthroscopical and radiological correlation of lever sign test for the diagnosis of anterior cruciate ligament rupture. Springerplus. 2015;4:830. PubMed ID:26753117 doi:10.1186/s40064-015-1628-9

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    Koster CH, Harmsen AM, Lichtenburg MC, Bloemers FW. ACL injury: how do the physical examination tests compare? J Fam Pract. 2018;67(3):130134. PubMed ID: 29509817

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Mulligan EP, Anderson A, Watson S, Dimeff RJ. The diagnostic accuracy of the lever sign for detecting anterior cruciate ligament injury. Intl J Sports Phys. 2017;12(7):10571067. doi:10.26603/ijspt20171057

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12.

    Lichtenburg MC, Koster CH, Teunissen LP, et al. Does the Lever Sign test have added value for diagnosing anterior cruciate ligament ruptures? Orthop J Sports Med. 2018;6(3):2325967118759631. PubMed ID: 29568784 doi:10.1177/2325967118759631

    • Search Google Scholar
    • Export Citation
  • 13.

    Ebell MH, Siwek J, Weiss BD, et al. Strength of recommendation taxonomy (SORT): a patient-centered approach to grading evidence in the medical literature. J Am Board Fam Pract. 2004;17(1):5967. PubMed ID: 15014055 doi:10.3122/jabfm.17.1.59

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14.

    Huang W, Zhang Y, Yao Z, Ma L. Clinical examination of the anterior cruciate ligament rupture: a systematic review and meta-analysis. Acta Orthop Traumatol Turc. 2016;50(1):2231. PubMed ID: 26854045

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Van Eck CF, van den Bekerom MP, Fu FH, Poolman RW, Kerkhoffs GM. Methods to diagnose acute anterior cruciate ligament rupture: a meta-analysis of physical examinations with and without anaesthesia. Knee Surg Sports Traumatol Arthrosc. 2013;21:18951903. PubMed ID: 23085822 doi:10.1007/s00167-012-2250-9

    • Crossref
    • Search Google Scholar
    • Export Citation
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