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Archives of Orthopaedic and Trauma Surgery

, Volume 134, Issue 10, pp 1451–1457 | Cite as

Can physical examination predict the intraarticular tear pattern of the anterior cruciate ligament?

  • Kyoung Ho Yoon
  • Sang Hak Lee
  • Soo Yeon Park
  • Dong Geun Kang
  • Kee Yun Chung
Arthroscopy and Sports Medicine

Abstract

Purpose

We evaluated the correlation between physical examinations and the tear patterns of the anterior cruciate ligament (ACL).

Materials and methods

From January 2003 to May 2007, we reviewed 201 cases of ACL rupture, diagnosed by MRI. Two orthopaedic surgeons (a fellow and a senior surgeon) evaluated the instability of the knee under anaesthesia: physical examinations were the anterior draw test (AD), Lachman test (LT), and pivot shift test (PT). By describing the rupture pattern and the site of the anteromedial (AMB) and posterolateral bundle (PLB) during arthroscopic examination, we analysed the correlation between the physical examination under anaesthesia and arthroscopic findings.

Results

In terms of the arthroscopic findings, rupture of the PLB was seen in 83 cases (41.3 %), of the AMB in 24 cases (11.9 %), and of both bundles in 94 cases (46.8 %). The kappa values for the physical examinations between the examiners were 0.963 (AD), 0.92 (LT), and 0.865 (PT). AD and LT above grade 2 did not differ significantly according to the pattern of rupture, but a PT above grade 2 was significantly different in ruptured PLB versus complete rupture.

Conclusions

A PT of more than grade 2 is a reliable physical examination for prediction of ruptured PLB or complete rupture.

Keywords

Knee ACL AM bundle rupture PM bundle rupture Physical examination 

Notes

Conflict of interest

The authors have declared that they have no conflict of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Kyoung Ho Yoon
    • 1
  • Sang Hak Lee
    • 1
  • Soo Yeon Park
    • 2
  • Dong Geun Kang
    • 1
  • Kee Yun Chung
    • 1
  1. 1.Department of Orthopaedic Surgery, School of MedicineKyung Hee UniversitySeoulSouth Korea
  2. 2.Department of Physical EducationGraduate School of Education, Yongin UniversityYonginSouth Korea

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