Lever sign test shows high diagnostic accuracy for anterior cruciate ligament injuries : A systematic review and meta-analysis of 3299 observations
Copyright © 2024 Elsevier B.V. All rights reserved..
PURPOSE: Injuries of the anterior cruciate ligament (ACL) are common knee injuries among active and younger patients. The Lever Sign Test (LST) is a relatively newer test, of which the accuracy is disputed in the existing literature. The aim of this study was to assess the accuracy with and without anesthesia of the Lever Sign test in the literature.
METHODS: PRISMA guidelines were followed, studies were identified using PubMed, EMBASE and Google Scholar. All studies that reported accuracy of LST performed by a clinical professional were included. Integrity of ACL was confirmed using magnetic resonance imaging or arthroscopy. Sensitivity and specificity were calculated using uni- and bivariate methods.
RESULTS: After inclusion, 3299 observations in 2516 patients were included from 23 studies. Mean age was 31.8 years and 64.2% were male. Without anesthesia, sensitivity was 79.2% (95% CI 68.7-86.9) and specificity was 92.0% (95% CI 82.2-96.6). An area under the curve (AUC) of 86.1% was found. With anesthesia, sensitivity was 86.6% (95% CI 68.0-95.2), specificity was 93.4% (95% CI 84.5-97.3) and the AUC was 91.6%.
CONCLUSION: The Lever Sign test shows very good to excellent accuracy for ACL injury, and is a useful tool for clinical practice.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:47 |
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| Enthalten in: |
The Knee - 47(2024) vom: 02. Feb., Seite 81-91 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Hesmerg, Mees K [VerfasserIn] |
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| Links: |
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| Themen: |
Anterior Cruciate Ligament (ACL) |
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| Anmerkungen: |
Date Revised 04.02.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1016/j.knee.2024.01.003 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM368003213 |
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| 245 | 1 | 0 | |a Lever sign test shows high diagnostic accuracy for anterior cruciate ligament injuries |b A systematic review and meta-analysis of 3299 observations |
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| 500 | |a Date Revised 04.02.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Copyright © 2024 Elsevier B.V. All rights reserved. | ||
| 520 | |a PURPOSE: Injuries of the anterior cruciate ligament (ACL) are common knee injuries among active and younger patients. The Lever Sign Test (LST) is a relatively newer test, of which the accuracy is disputed in the existing literature. The aim of this study was to assess the accuracy with and without anesthesia of the Lever Sign test in the literature | ||
| 520 | |a METHODS: PRISMA guidelines were followed, studies were identified using PubMed, EMBASE and Google Scholar. All studies that reported accuracy of LST performed by a clinical professional were included. Integrity of ACL was confirmed using magnetic resonance imaging or arthroscopy. Sensitivity and specificity were calculated using uni- and bivariate methods | ||
| 520 | |a RESULTS: After inclusion, 3299 observations in 2516 patients were included from 23 studies. Mean age was 31.8 years and 64.2% were male. Without anesthesia, sensitivity was 79.2% (95% CI 68.7-86.9) and specificity was 92.0% (95% CI 82.2-96.6). An area under the curve (AUC) of 86.1% was found. With anesthesia, sensitivity was 86.6% (95% CI 68.0-95.2), specificity was 93.4% (95% CI 84.5-97.3) and the AUC was 91.6% | ||
| 520 | |a CONCLUSION: The Lever Sign test shows very good to excellent accuracy for ACL injury, and is a useful tool for clinical practice | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Anterior Cruciate Ligament (ACL) | |
| 650 | 4 | |a Clinical test | |
| 650 | 4 | |a Diagnostic accuracy | |
| 650 | 4 | |a Lelli test | |
| 650 | 4 | |a Lever Sign test | |
| 700 | 1 | |a Oostenbroek, Maurits H W |e verfasserin |4 aut | |
| 700 | 1 | |a van der List, Jelle P |e verfasserin |4 aut | |
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