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Stability tests in knee ligament injuries.

R Sandberg, B Balkfors, A Henricson

    Archives of Orthopaedic and Traumatic Surgery. Archiv Fur Orthopadische Und Unfall-Chirurgie
    |January 1, 1986
    PubMed
    Summary
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    Accurate knee ligament injury diagnosis relies on specific stability tests. While some tests are effective without anesthesia, others, like the pivot shift, require it for reliable anterior cruciate ligament and medial collateral ligament injury detection.

    Area of Science:

    • Orthopedic Surgery
    • Sports Medicine
    • Biomechanics of the Knee

    Background:

    • Ligamentous injuries of the knee are common, often requiring surgical intervention.
    • Accurate pre-operative assessment of knee joint stability is crucial for surgical planning.
    • Various clinical tests exist to evaluate knee ligament integrity, but their reliability varies.

    Purpose of the Study:

    • To evaluate the diagnostic accuracy of clinical stability tests for knee ligamentous injuries.
    • To compare the effectiveness of specific tests with and without anesthesia.
    • To determine the reliability of these tests in guiding surgical decisions.

    Main Methods:

    • Retrospective analysis of 182 knee joints with surgically confirmed ligamentous injuries.

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  • Review of documented pre-operative stability examinations, including Lachman test, anterior drawer sign, pivot shift, and valgus stress tests.
  • Comparison of test accuracy with and without anesthesia.

    • Main Results:

    • Lachman test and anterior drawer sign had similar false-negative rates (50%) for anterior cruciate ligament injuries, improving under anesthesia.
    • Pivot shift test was only useful for diagnosis when performed under anesthesia.
    • Medial collateral ligament injuries were typically identified via valgus instability testing, often without anesthesia.

    Conclusions:

    • Stability tests performed under anesthesia provide reliable data for surgical decision-making in knee ligament injuries.
    • Anesthesia enhances the accuracy of certain tests, particularly for anterior cruciate ligament and pivot shift assessment.
    • Valgus stress testing is effective for diagnosing medial collateral ligament injuries without anesthesia.