Valen S, McCabe C, Maddock E, Bright S, Keeley B
Northwest Surgeons, Sutton Weaver, Cheshire, WA7 3FW.
J Small Anim Pract. 2017 Feb;58(2):109-114. doi: 10.1111/jsap.12619.
To assess diagnostic efficacy of a modified tibial compression test in predicting medial meniscal injury in dogs with cranial cruciate ligament failure.
Dogs admitted for surgical stabilisation of stifles with cranial cruciate ligament failure were examined by five preoperative physical tests to assess medial meniscal injury. Results of each physical test were compared with findings at arthrotomy and used to calculate sensitivities, specificities, positive and negative predictive values.
None of the physical tests were accurate in reflecting meniscal integrity for dogs with cranial cruciate failure. Out of the five tests, the modified tibial compression test exhibited the highest concordance and sensitivity for the detection of medial meniscal tears. A palpable click during the modified tibial compression test had a sensitivity and specificity up to 63 and 77%, respectively, for the detection of medial meniscal lesions. Concordance values were up to 40% for the modified tibial compression test, followed by the range of motion test (up to 25%), while all other physical tests had concordance values below 10%.
Physical tests are highly available, affordable and can be easily performed, but their efficacy in diagnosing medical meniscal injury is low. Meniscal clicks associated with meniscal tears were more frequently elicited during the modified tibial compression test when compared with other traditional tests.
评估改良胫骨挤压试验对诊断患有颅交叉韧带断裂的犬内侧半月板损伤的有效性。
对因颅交叉韧带断裂而接受膝关节手术固定的犬，术前通过五项体格检查来评估内侧半月板损伤情况。将每项体格检查的结果与关节切开术的发现进行比较，并用于计算敏感性、特异性、阳性预测值和阴性预测值。
对于患有颅交叉韧带断裂的犬，没有一项体格检查能准确反映半月板的完整性。在这五项检查中，改良胫骨挤压试验在检测内侧半月板撕裂方面表现出最高的一致性和敏感性。改良胫骨挤压试验过程中可触及的弹响，对于检测内侧半月板损伤的敏感性和特异性分别高达63%和77%。改良胫骨挤压试验的一致性值高达40%，其次是活动范围试验（高达25%），而所有其他体格检查的一致性值均低于10%。
体格检查具有高度可及性、价格低廉且易于实施，但其诊断内侧半月板损伤的有效性较低。与其他传统检查相比，改良胫骨挤压试验过程中与半月板撕裂相关的半月板弹响更常被引出。
