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The Albright-Losee Low Profile Pivot Shift Test for ACL Deficiency.

Brandon Bates1, Allison Methenitis2, Kevin Dibbern3

  • 1Dell Medical School, The University of Texas at Austin, Austin, Texas, USA.

The Iowa Orthopaedic Journal
|January 15, 2025
PubMed
Summary
This summary is machine-generated.

Diagnosing anterior cruciate ligament (ACL) tears in awake patients is challenging. The modified Albright-Losee Test offers high sensitivity and specificity, proving valuable for sports medicine providers.

Keywords:
ACLACL ruptureanterior cruciate ligamentoffice examination

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Diagnostic Imaging

Background:

  • Diagnosing anterior cruciate ligament (ACL) injuries in awake patients presents significant clinical challenges.
  • Existing pivot-shift techniques often lack sufficient sensitivity for reliable ACL injury detection.
  • This study introduces modifications to enhance a novel screening procedure for ACL disruption.

Purpose of the Study:

  • To describe and critically review modifications of a novel screening procedure for ACL disruption.
  • To improve the accuracy of diagnosing ACL injuries in awake, apprehensive patients.
  • To provide guidance for clinicians to master this screening technique.

Main Methods:

  • 18 cadavers were used to assess instability kinematics.
  • Clinical studies involved 208 patients with ACL deficiency and 47 with intact ACLs, examined by multiple clinicians.
  • Data were collected on patient condition, examiner experience, and diagnostic outcomes.

Main Results:

  • Cadaveric analysis revealed specific patterns of anterior translation-internal rotation laxity.
  • The novel clinical test demonstrated high sensitivity (94.7%) and specificity (97.3%) for ACL tears.
  • Factors like pain, anxiety, and hamstring guarding presented challenges but did not negate test efficacy.

Conclusions:

  • The modified Albright-Losee Test, when instability is perceived by both patient and examiner, significantly aids in determining ACL status.
  • This test exhibits superior sensitivity compared to the Lachman Test in awake patients.
  • With a positive predictive value of 98.8%, the test is highly valuable for sports medicine professionals, even amidst challenging clinical factors.