Dawod Moh'd S, Alswerki Mohammad N, Darabah Asem J, Darabah Yazeed J, Akel Alaa Y, Alisi Mohammed S
Department of Orthopedic Surgery, Mu'tah School of Medicine, Mu'tah University, Al-karak, Jordan.
Department of Orthopedic Surgery, Jordan University Hospital, Amman, Jordan.
Adv Med Educ Pract. 2023 Mar 28;14:289-295. doi: 10.2147/AMEP.S402496. eCollection 2023.
Injuries to the anterior cruciate ligament (ACL) in sports are frequent in children and young adults participating in sporting activities involving rotational and pivoting movements. Magnetic resonance imaging is the most accurate diagnostic tool to detect an ACL tear. There are, however, a number of specialized tests available to assess ACL competency.
A novel test was described with extremely high clinical accuracy. The purpose of this study was to assess its clinical accuracy when performed by non-orthopedic providers, such as medical students.
A cross-sectional study design was adopted, and two patients with an MRI-proven complete ACL tear were selected. One patient was thin, and the other was overweight, and both were examined by 100 medical students for both the injured and uninjured knee. The results for these exams were recorded, and a statistical analysis of the screening test was done to evaluate the new special test.
Our results were different from the ones found in the literature: we found the test to have a significantly lower performance in terms of sensitivity, specificity, and positive and negative likelihood ratios compared to the literature numbers.
The Lever sign (Lelli's) test loses clinical credibility and significance when performed by non-orthopedic providers or doctors, such as medical students in our study.
在参与涉及旋转和枢转运动的体育活动的儿童和年轻人中，运动时前交叉韧带（ACL）损伤很常见。磁共振成像（MRI）是检测ACL撕裂最准确的诊断工具。然而，有许多专门的测试可用于评估ACL功能。
描述了一种具有极高临床准确性的新型测试。本研究的目的是评估由非骨科医生（如医学生）进行该测试时的临床准确性。
采用横断面研究设计，选择两名经MRI证实为完全ACL撕裂的患者。一名患者体型瘦，另一名患者超重，100名医学生对两名患者的受伤膝关节和未受伤膝关节都进行了检查。记录这些检查的结果，并对筛查测试进行统计分析以评估这种新的特殊测试。
我们的结果与文献中的结果不同：我们发现该测试在敏感性、特异性以及阳性和阴性似然比方面的表现明显低于文献中的数字。
当由非骨科医生或医生（如我们研究中的医学生）进行时，杠杆征（莱利氏）测试失去了临床可信度和意义。
