scholarly journals Intertester reliability of the Modified Anterior Drawer (Lachman) Test for anterior cruciate ligament laxity

1991 ◽  
Vol 37 (3) ◽  
pp. 163-168 ◽  
Author(s):  
Nick P Duggan ◽  
Janet C Ross
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Anterior Drawer ◽  
Lachman Test ◽  
Ligament Laxity ◽  
Anterior Cruciate

scholarly journals A modified anterior drawer test for anterior cruciate ligament ruptures

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Guang-lei Zhao ◽  
Jin-yang Lyu ◽  
Chang-quan Liu ◽  
Jian-guo Wu ◽  
Jun Xia ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Pivot Shift ◽  
Cruciate Ligament ◽  
Characteristic Curve ◽  
Pivot Shift Test ◽  
Anterior Drawer ◽  
Lachman Test ◽  
Anterior Drawer Test ◽  
Significant Difference ◽  
Anterior Cruciate

Abstract Objective This study was aimed to utilize a modified anterior drawer test (MADT) to detect the anterior cruciate ligament (ACL) ruptures and investigate its accuracy compares with three traditional tests. Methods Four hundred patients were prospectively enrolled between January 2015 and September 2017 preoperatively to undergo knee arthroscopic surgeries. The MADT, anterior drawer test, Lachman test, and pivot shift test were used in the outpatient clinical setting and were compared statistically for their accuracy in terms of ACL ruptures, with arthroscopic findings as the gold standard. Results The prevalence of ACL ruptures in this study was 37.0%. The MADT demonstrated the highest sensitivity (0.89) and accuracy (0.92) among the four tests and had comparable specificity (0.94) and a positive predictive value (0.90) compared with the anterior drawer test, Lachman test, and pivot shift test. The diagnostic odds ratio (DOR) of MADT was 122.92, with other test values of no more than 55.45. The area under the receiver operating characteristic curve (AUC) for the MADT was 0.92 ± 0.01, with a significant difference compared with that for the anterior drawer test (z = 17.00, p < 0.001), Lachman test (z = 9.66, p = 0.002), and pivot shift test (z = 16.39, p < 0.001). The interobserver reproducibility of the MADT was good, with a kappa coefficient of 0.86. When diagnosing partial tears of ACL, the MADT was significantly more sensitive than the anterior drawer test (p < 0.001), Lachman test (p = 0.026), and pivot shift test (p = 0.013). The MADT showed similar sensitivity in detecting anteromedial and posterolateral bundle tears (p = 0.113) and no difference in diagnosing acute and chronic ACL ruptures (χ2 = 1.682, p = 0.195). Conclusions The MADT is also an alternative diagnostic test to detect ACL tear, which is equally superior to the anterior drawer test, Lachman test, and pivot shifting test. It could improve the diagnosis of ACL ruptures combined with other clinical information including injury history, clinical examination, and radiological findings. Levels of evidence Level II/observational diagnostic studies Trial registration Chinese Clinical Trial Registry. ChiCTR1900022945 /retrospectively registered

scholarly journals Magnetic Tracking: A Novel Method of Assessing Anterior Cruciate Ligament Deficiency

2006 ◽  
Vol 88 (1) ◽  
pp. 16-17 ◽  
Author(s):  
RK Kundra ◽  
JD Moorehead ◽  
N Barton-Hanson ◽  
SC Montgomery
Keyword(s):  
Anterior Cruciate Ligament ◽  
Tracking System ◽  
Cruciate Ligament ◽  
Magnetic Tracking ◽  
Lachman Test ◽  
Acl Deficiency ◽  
Anterior Tibial ◽  
Anterior Cruciate ◽  
Tracking Device ◽  
Acl Deficient

INTRODUCTION The Lachman test is commonly performed as part of the routine assessment of patients with suspected anterior cruciate ligament (ACL) deficiency. A major drawback is its reliance on the clinician's subjective judgement of movement. The aim of this study was to quantify Lachman movement using a magnetic tracking device thereby providing a more accurate objective measure of movement. PATIENTS AND METHODS Ten patients aged 21–51 years were assessed as having unilateral ACL deficiency with conventional clinical tests. These patients were then re-assessed using a Polhemus Fastrak™ magnetic tracking device. RESULTS The mean anterior tibial displacement was 5.6 mm (SD = 2.5) for the normal knees and 10.2 mm (SD = 4.2) for the ACL-deficient knees. This gave an 82% increase in anterior tibial displacement for the ACL deficient knees. This was shown to be highly significant with P = 0.005. CONCLUSIONS The magnetic tracking system offers an objective quantification of displacements during the Lachman test. It is convenient, non-invasive and comfortable for the patient and is, therefore, ideally suited for use as an investigative tool.

Correlation of Estradiol in Pregnancy and Anterior Cruciate Ligament Laxity

2001 ◽  
Vol 387 ◽  
pp. 165-170 ◽  
Author(s):  
William P. H. Charlton ◽  
Lynne M. Coslett-Charlton ◽  
Michael G. Ciccotti
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Ligament Laxity ◽  
Anterior Cruciate ◽  
In Pregnancy

Long-term Failure of Thermal Shrinkage for Laxity of the Anterior Cruciate Ligament

2005 ◽  
Vol 33 (7) ◽  
pp. 990-995 ◽  
Author(s):  
Jeffrey Halbrecht
Keyword(s):  
Anterior Cruciate Ligament ◽  
Thermal Energy ◽  
Cruciate Ligament ◽  
Thermal Shrinkage ◽  
Partial Tears ◽  
Kt 1000 ◽  
Ligament Laxity ◽  
Anterior Cruciate

Background Appropriate treatment for anterior cruciate ligament laxity, owing to partial tears of the native ligament or lax reconstruction, is unclear. Studies suggest that a significant percentage of these untreated tears may progress to complete tears or the patient may develop additional injuries to the meniscus or articular cartilage. Shrinkage of the ligament or graft using thermal energy has been proposed as a solution for this problem. Purpose To evaluate the long-term results using thermal energy to shrink laxity of the anterior cruciate ligament. Study Design Case series; Level of evidence, 4. Methods Nineteen patients with partial tears of the anterior cruciate ligament (n = 14) or stretched anterior cruciate ligament grafts (n = 5) underwent thermal shrinkage treatment. Fourteen were available for follow-up at 1 and 5 years. At 1 year, there were 12 partial tears and 2 grafts available for evaluation. At 5 years, there were 10 partial tears and 4 grafts. Preoperative, postoperative, and intraoperative stability testing was performed using the KT-1000 arthrometer. Clinical results were evaluated using the Cincinnati and Lysholm scoring systems. Results Intraoperative shrinkage averaged 2.12 mm (17%, P <. 0001). At 1 year, 12 of the 14 patients remained stable (86%) with a negative Lachman test result and mean KT-1000 arthrometer maximum side-to-side score of 1.29 mm (P <. 001). The 2 failed shrinkages were partial tears of the native anterior cruciate ligament. For these 12 patients, Cincinnati scores improved from 53 to 89 (P <. 0001), and Lysholm scores improved from 55 to 89 (P <. 0003). At 5-year follow-up, 11 of 13 patients had gone on to complete failure (85%, P <. 002; 8/9 partial tears and 3/4 grafts). Conclusion Thermal shrinkage provides short-term benefit in the treatment of anterior cruciate ligament laxity but leads to catastrophic failure in the majority of patients at long-term follow-up. We can no longer recommend this procedure for the treatment of anterior cruciate ligament laxity.

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