Istanbul Training and Research Hospital, Department of Orthopedics and Traumatology, Istanbul, Turkey.
University of Kyrenia, Faculty of Medicine, Department of Orthopaedics and Traumatology, Kyrenia, Cyprus.
Biomed Res Int. 2019 Jun 9;2019:3639693. doi: 10.1155/2019/3639693. eCollection 2019.
The aim of this study is to determine the diagnostic accuracy of lever sign test in acute, chronic, and postreconstructive ACL injuries.
In total, 78 patients (69 male, 9 female) were subjected to clinical instability tests including Lachman, anterior drawer, pivot shift, and lever sign when an injury of the ACL was suspected. All tests were performed bilaterally in all patients in acute, chronic period and patients who underwent surgery after the anaesthesia and after the reconstruction at the last follow-up by two senior orthopaedic surgeons. MRI was taken from all patients and MRI image was taken as the reference test when evaluating the accuracy of the tests.
The mean age of patients was 26.2±6.4 years (range, 17-44 years). Sensitivity and accuracy values of the Lachman, anterior drawer, pivot shift, and lever tests in the acute phase were calculated as 80.6%, 77.4%, 51.6%, 91.9% and 76.9%, 75.6%, 60.3%, 92.3%, respectively, and in the chronic (preanaesthesia) phase were calculated as 83.9%, 79.0%, 56.5%, 91.9% and 80.8%, 78.2%, 64.1%, 92.3%, respectively. Lachman, anterior drawer, pivot shift, and lever sign Acute's significant [AUC: 0.716, 0.731, 0.727, 0.928, respectively] activity were observed in the prediction of ACL rupture in MRI.
An ideal test to diagnose the integrity of the ACL should be easy to perform and reproducible with high sensitivity and specificity. From this perspective, the lever test seems to be a good test for clinicians in acute, chronic and postreconstructive ACL injuries.
本研究旨在确定杠杆征试验在急性、慢性和重建后 ACL 损伤中的诊断准确性。
总共对 78 例（69 例男性，9 例女性）患者进行了临床不稳定测试，包括当怀疑 ACL 受伤时的 Lachman、前抽屉、枢轴移位和杠杆征测试。所有患者在急性、慢性期以及麻醉后和最后一次随访时手术后均由两名资深骨科医生进行双侧检查。所有患者均进行了 MRI 检查，并在评估测试准确性时将 MRI 图像作为参考测试。
患者的平均年龄为 26.2±6.4 岁（范围，17-44 岁）。在急性阶段，Lachman、前抽屉、枢轴移位和杠杆测试的灵敏度和准确性值分别计算为 80.6%、77.4%、51.6%、91.9%和 76.9%、75.6%、60.3%、92.3%，在慢性（麻醉前）阶段分别计算为 83.9%、79.0%、56.5%、91.9%和 80.8%、78.2%、64.1%、92.3%。Lachman、前抽屉、枢轴移位和杠杆征在 MRI 预测 ACL 破裂中的急性显著[AUC：0.716、0.731、0.727、0.928]活动。
一种理想的用于诊断 ACL 完整性的测试应该易于进行，并且具有高灵敏度和特异性。从这个角度来看，杠杆征测试对于急性、慢性和重建后 ACL 损伤的临床医生来说似乎是一种很好的测试。
