Systematic reviewThe reliability of physical examination tests for the diagnosis of anterior cruciate ligament rupture – A systematic review
Section snippets
Background
Rupture of the anterior cruciate ligament (ACL) is a severe knee injury, which is often acquired during sporting activities (Alentorn-Geli et al., 2009, Gianotti et al., 2009), and often results in instability. This subsequently leads to meniscal and cartilage lesions and/or functional impairments (Lohmander et al., 2004, Michalitsis et al., 2013, Sri-Ram et al., 2013). Early diagnosis and treatment is therefore necessary. To diagnose an ACL tear, information obtained from patient history,
Objective
To our knowledge, there have been no published systematic reviews conducted to determine the intra- and interrater reliability of physical examination tests for ACL injuries. Accordingly, the objective of this systematic review was to summarize and evaluate intra- and interrater reliability research on physical examination tests used for the diagnosis of ACL tears.
Data sources and search strategy
We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines during the whole searching and reporting process of this review (Moher et al., 2009). The PRISMA statement aims to improve the reporting of systematic reviews and meta-analyses.
We executed a comprehensive systematic literature search in the following databases via the Ovid interface until May 30th, 2013: MEDLINE from 1946, EMBASE from 1974, and the Allied and Complementary Medicine Database (AMED)
Study selection
The summary of the literature search results and study selection can be seen in the PRISMA flow chart (Fig. 2) as described in the PRISMA statement (Moher et al., 2009). After evaluation of the 110 search hits, 19 publications met the predefined criteria and were retrieved and checked for eligibility (Althoff et al., 1981, Wirth and Kolb, 1985, Decker and Ruf, 1988, Cooperman et al., 1990, Duggan and Ross, 1991, Fleming et al., 1992, Scharlig et al., 1992, Gambaretti et al., 1995, Konig et al.,
Main findings
This systematic review identified seven articles, which examined the reliability of four physical examination tests with varying intrarater as well as interrater reliability. The included studies were partly of low methodological quality according to the methodological assessment using the QAREL tool. Because of methodological quality flaws, different and partially inadequate reliability measures of included studies, meta-analysis of results was not possible.
Intrarater reliability
According to our results, the
Acknowledgement
The authors would like to thank Dr Janice Hegewald from the Technical University Dresden for the English language review.
References (61)
- et al.
The STARD initiative
Lancet
(2003) - et al.
Reliability: what is it, and how is it measured?
Physiotherapy
(2000) - et al.
Bias, prevalence and kappa
J Clin Epidemiol
(1993) - et al.
Clinical screening tests for assessing movement control in non-specific low-back pain. A systematic review of intra- and inter-observer reliability studies
Man Ther
(2013) - et al.
High agreement but low kappa .2. Resolving the paradoxes
J Clin Epidemiol
(1990) - et al.
When to use agreement versus reliability measures
J Clin Epidemiol
(2006) - et al.
High agreement but low kappa .1. The problems of 2 paradoxes
J Clin Epidemiol
(1990) - et al.
Incidence of anterior cruciate ligament injury and other knee ligament injuries: a national population-based study
J Sci Med Sport
(2009) Weighted 2 × 2 kappa coefficients: recommended indices of diagnostic accuracy for evidence-based practice
J Clin Epidemiol
(2009)- et al.
Guidelines for reporting reliability and agreement studies (GRRAS) were proposed
J Clin Epidemiol
(2011)
Comparative outcome analysis of malpositioned and properly positioned fixation groups after hamstring autograft ACL reconstruction with femoral cross-pin fixation
Knee
The development of a quality appraisal tool for studies of diagnostic reliability (QAREL)
J Clin Epidemiol
Evaluation of anterior knee laxity on MRI
Ann Phys Rehabil Med
Physical examination of the knee: a review of the original test description and scientific validity of common orthopedic tests
Arch Phys Med Rehabil
Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement
J Clin Epidemiol
The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes
J Clin Epidemiol
What makes a measurement instrument valid and reliable?
Injury
A systematic review classifies sources of bias and variation in diagnostic test accuracy studies
J Clin Epidemiol
Reliability of the KT1000 arthrometer and the Lachman test in patients with an ACL rupture
Knee
Prevention of non-contact anterior cruciate ligament injuries in soccer players. Part 1: mechanisms of injury and underlying risk factors
Knee Surg Sports Traumatol Arthrosc
Clinical diagnosis in cases of rupture of the anterior cruciate ligament
Lakartidningen
Statistical methods for assessing measurement error (reliability) in variables relevant to sports medicine
Sports Med
Evaluation of anterior knee joint instability with the Rolimeter. A test in comparison with manual assessment and measuring with the KT-1000 arthrometer
Knee Surg Sports Traumatol Arthrosc
Clinical diagnosis of an anterior cruciate ligament rupture: a meta-analysis
J Orthop Sports Phys Ther
Towards complete and accurate reporting of studies of diagnostic accuracy: the STARD initiative
BMJ
A coefficient of agreement for nominal scales
Educ Psychol Meas
Reliability and validity of judgments of the integrity of the anterior cruciate ligament of the knee using the Lachman's test
Phys Ther
Clinicians are right not to like Cohen's kappa
BMJ
The diagnostic certainty of various methods of evaluating recent trauma to knee ligaments
Unfallchirurgie
The pivot shift test is of limited clinical relevance in the arthritic anterior cruciate ligament-deficient knee
J Knee Surg
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The first two authors (A.F. and T.L.) contributed equally to this work.