Diagnostic ACL Injuries: Orthopedic Tests
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Several weeks ago Cub Swanson suffered a knee injury during a knee reap by Jake Shields in Quintet. Diagnostic imaging confirmed that Swanson suffered a complete ACL tear and meniscus tear. The gold standard for diagnosis ligament injuries is still using an MRI however clinicians can perform several orthopedic tests to increase their confidence that a ligament is compromised and requires imaging.
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Here are two videos performed by @drnimamehran of orthopedic tests to diagnose an ACL tear.
Lachman Test: Here the physician assessed the anterior laxity of the tibia on the femur.
Sensitivity: 77.7%
Specificity: >95%
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Pivot Shift test: Here the physician will assess if the tibia can be subluxed with reduction at 30-40 degrees of flexion.
Sensitivity: 18-48%
Specificity: 97-99%
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Both tests have high specificity so they are useful in ruling in tears.
Here @drnimamehran assesses the laxity in the knee pre-surgery. Often surgeons will perform these tests again following completing surgery to know whether the knee still has passive laxity or not.