Rupture of Anterior Cruciate Ligaments and the Lever Test in Diagnosis: A Critical Review

Anterior Cruciate Ligament (ACL) rupture is known to be one of the most common musculoskeletal injuries in active individuals especially athletes. Approximately 200.000 ACL injuries occur every year of which 100,000 require surgery. Once ruptured, it becomes very difficult to regain its previous function and it does not have the capacity to heal on its own. It is thus very important to diagnose an ACL rupture as early as possible. Clinicians thus need to perform a test which has a high sensitivity to rule out a negative test and specificity in order to rule in a positive test in the diagnosis. In this review four different tests (Lever Sign Test, Lachman test, Anterior drawer test and Pivot Shift Test) are compared among each other to find out the better option among the selected tests.