Simon Décary1, Philippe Ouellet2, Pascal-André Vendittoli3, Jean-Sébastien Roy4, François Desmeules5. 1. School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada; Orthopaedic Clinical Research Unit, Maisonneuve-Rosemont Hospital Research Center, University of Montreal Affiliated Research Center, Montreal, Quebec, Canada. Electronic address: simon.decary.1@umontreal.ca. 2. School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada; Orthopaedic Clinical Research Unit, Maisonneuve-Rosemont Hospital Research Center, University of Montreal Affiliated Research Center, Montreal, Quebec, Canada. Electronic address: philippe.ouellet.3@umontreal.ca. 3. Orthopaedic Clinical Research Unit, Maisonneuve-Rosemont Hospital Research Center, University of Montreal Affiliated Research Center, Montreal, Quebec, Canada; Department of Surgery, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, Quebec, Canada. Electronic address: pa_vendittoli@hotmail.com. 4. Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada; Centers for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Canada. Electronic address: jean-sebastien.roy@fmed.ulaval.ca. 5. School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada; Orthopaedic Clinical Research Unit, Maisonneuve-Rosemont Hospital Research Center, University of Montreal Affiliated Research Center, Montreal, Quebec, Canada. Electronic address: f.desmeules@umontreal.ca.
Abstract
INTRODUCTION: More evidence on diagnostic validity of physical examination tests for knee disorders is needed to lower frequently used and costly imaging tests. OBJECTIVE: To conduct a systematic review of systematic reviews (SR) and meta-analyses (MA) evaluating the diagnostic validity of physical examination tests for knee disorders. METHODS: A structured literature search was conducted in five databases until January 2016. Methodological quality was assessed using the AMSTAR. RESULTS: Seventeen reviews were included with mean AMSTAR score of 5.5 ± 2.3. Based on six SR, only the Lachman test for ACL injuries is diagnostically valid when individually performed (Likelihood ratio (LR+):10.2, LR-:0.2). Based on two SR, the Ottawa Knee Rule is a valid screening tool for knee fractures (LR-:0.05). Based on one SR, the EULAR criteria had a post-test probability of 99% for the diagnosis of knee osteoarthritis. Based on two SR, a complete physical examination performed by a trained health provider was found to be diagnostically valid for ACL, PCL and meniscal injuries as well as for cartilage lesions. CONCLUSION: When individually performed, common physical tests are rarely able to rule in or rule out a specific knee disorder, except the Lachman for ACL injuries. There is low-quality evidence concerning the validity of combining history elements and physical tests.
INTRODUCTION: More evidence on diagnostic validity of physical examination tests for knee disorders is needed to lower frequently used and costly imaging tests. OBJECTIVE: To conduct a systematic review of systematic reviews (SR) and meta-analyses (MA) evaluating the diagnostic validity of physical examination tests for knee disorders. METHODS: A structured literature search was conducted in five databases until January 2016. Methodological quality was assessed using the AMSTAR. RESULTS: Seventeen reviews were included with mean AMSTAR score of 5.5 ± 2.3. Based on six SR, only the Lachman test for ACL injuries is diagnostically valid when individually performed (Likelihood ratio (LR+):10.2, LR-:0.2). Based on two SR, the Ottawa Knee Rule is a valid screening tool for knee fractures (LR-:0.05). Based on one SR, the EULAR criteria had a post-test probability of 99% for the diagnosis of knee osteoarthritis. Based on two SR, a complete physical examination performed by a trained health provider was found to be diagnostically valid for ACL, PCL and meniscal injuries as well as for cartilage lesions. CONCLUSION: When individually performed, common physical tests are rarely able to rule in or rule out a specific knee disorder, except the Lachman for ACL injuries. There is low-quality evidence concerning the validity of combining history elements and physical tests.
Authors: S Décary; M Fallaha; B Pelletier; P Frémont; J Martel-Pelletier; J-P Pelletier; D E Feldman; M-P Sylvestre; P-A Vendittoli; F Desmeules Journal: BMC Musculoskelet Disord Date: 2017-11-14 Impact factor: 2.362
Authors: Pawel A Sokal; Richard Norris; Thomas W Maddox; Rachel A Oldershaw Journal: Knee Surg Sports Traumatol Arthrosc Date: 2022-02-12 Impact factor: 4.114
Authors: Angélica Campón Chekroun; Jorge Velázquez-Saornil; Isabel Guillén Vicente; Zacarías Sánchez Milá; David Rodríguez-Sanz; Carlos Romero-Morales; Tomas Fernandez-Jaén; José Ignacio Garrido González; Miguel Ángel Sánchez-Garrido; Pedro Guillén García Journal: World J Orthop Date: 2022-09-18
Authors: Qiuke Wang; Jos Runhaar; Margreet Kloppenburg; Maarten Boers; Johannes W J Bijlsma; Sita M A Bierma-Zeinstra Journal: J Clin Med Date: 2020-10-21 Impact factor: 4.241