Physical examination tests for the diagnosis of posterior cruciate ligament rupture: A systematic review

Journal of Orthopaedic and Sports Physical Therapy

Volumn 43, Issue 11, 2013, Pages 804-813

  Kopkow, Christian ^a,b   Freiberg, Alice ^b   Kirschner, Stephan ^a   Seidler, Andreas ^b   Schmitt, Jochen ^a,b  

^a UNIVERSITY HOSPITAL CARL GUSTAV CARUS   (Germany)

^b DRESDEN UNIVERSITY OF TECHNOLOGY   (Germany)

Author keywords

Posterior cruciate ligament; Posterior drawer; Posterior sag sign; Quadriceps active; Sensitivity; Specificity; Systematic review

Indexed keywords

HUMAN; INJURY; KNEE INJURY; KNEE LIGAMENT; PHYSICAL EXAMINATION; REVIEW;

HUMANS; KNEE INJURIES; PHYSICAL EXAMINATION; POSTERIOR CRUCIATE LIGAMENT;

EID: 84903875075     PISSN: 01906011     EISSN: None     Source Type: Journal    
DOI: 10.2519/jospt.2013.4906     Document Type: Review

References (93)

1. Allen CR, Kaplan LD, Fluhme DJ, Harner CD. Posterior cruciate ligament injuries. Curr Opin Rheumatol. 2002;14:142-149.
2. Anderson AF, Lipscomb AB. Preoperative instrumented testing of anterior and posterior knee laxity. Am J Sports Med. 1989;17:387-392.
3. Bachmann LM, Puhan MA, ter Riet G, Bossuyt PM. Sample sizes of studies on diagnostic accuracy: literature survey. BMJ. 2006;332:1127-1129. http://dx.doi.org/10.1136/bmj.38793.637789.2F
4. Baker CL, Jr., Norwood LA, Hughston JC. Acute combined posterior cruciate and posterolateral instability of the knee. Am J Sports Med. 1984;12:204-208.
5. Benedetto KP, Sperner G, Glötzer W. [Knee joint hemarthrosis - differential diagnostic considerations for planning an operation]. Orthopäde. 1990;19:69-76.
6. Bertschmann W, Staubli HU, Noesberger B. Role of a simple diagnostic test in recent injuries to the knee joint. Helv Chir Acta. 1982;48:685-691.
7. Bomberg BC, McGinty JB. Acute hemarthrosis of the knee: indications for diagnostic arthroscopy. Arthroscopy. 1990;6:221-225.
8. Bossuyt PM, Reitsma JB. The STARD initiative. Lancet. 2003;361:71. http://dx.doi.org/10.1016/S0140-6736(03)12122-8
9. Bossuyt PM, Reitsma JB, Bruns DE, et al. Towards complete and accurate reporting of studies of diagnostic accuracy: the STARD initiative. BMJ. 2003;326:41-44. http://dx.doi.org/10.1136/bmj.326.7379.41
10. Bossuyt PM, Reitsma JB, Bruns DE, et al. The STARD statement for reporting studies of diagnostic accuracy: explanation and elaboration. Ann Intern Med. 2003;138:W1-W12. http://dx.doi.org/10.7326/0003-4819-138-1- 200301070-00012-w1
11. Budoff JE, Nirschl RP. Knee problems: diagnostic tests for ligament injuries. Consultant. 2013;53:629-632.
12. Clendenin MB, DeLee JC, Heckman JD. Interstitial tears of the posterior cruciate ligament of the knee. Orthopedics. 1980;3:764-772.
13. Cook C, Mabry L, Reiman MP, Hegedus EJ. Best tests/clinical findings for screening and diagnosis of patellofemoral pain syndrome: a systematic review. Physiotherapy. 2012;98:93-100. http://dx.doi.org/10.1016/j.physio.2011.09.001
14. Daniel DM, Stone ML, Barnett P, Sachs R. Use of the quadriceps active test to diagnose posterior cruciate-ligament disruption and measure posterior laxity of the knee. J Bone Joint Surg Am. 1988;70:386-391.
15. Decker R, Ruf W. [The diagnostic certainty of various methods of evaluating recent trauma to knee ligaments]. Unfallchirurgie. 1988;14:204-210.
16. de Vet HCW, Eisinga A, Riphagen II, Aertgeerts B, Pewsner D. Chapter 7: searching for studies. In: Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy Version 0.4. Oxford, UK: The Cochrane Collaboration; 2008.
17. Dexel M. Diagnostic procedure in instabilities of the knee. Orthop Praxis. 1977:500-503.
18. Esmaili Jah AA, Keyhani S, Zarei R, Moghaddam AK. Accuracy of MRI in comparison with clinical and arthroscopic findings in ligamentous and meniscal injuries of the knee. Acta Orthop Belg. 2005;71:189-196.
19. Fanelli GC. Posterior cruciate ligament injuries in trauma patients. Arthroscopy. 1993;9:291-294.
20. Fanelli GC, Edson CJ. Posterior cruciate ligament injuries in trauma patients: part II. Arthroscopy. 1995;11:526-529.
21. Feltham GT, Albright JP. The diagnosis of PCL injury: literature review and introduction of two novel tests. Iowa Orthop J. 2001;21:36-42.
22. Ferrari DA, Ferrari JD, Coumas J. Posterolateral instability of the knee. J Bone Joint Surg Br. 1994;76:187-192.
23. Fischer SP, Fox JM, Del Pizzo W, Friedman MJ, Snyder SJ, Ferkel RD. Accuracy of diagnoses from magnetic resonance imaging of the knee. A multi-center analysis of one thousand and fourteen patients. J Bone Joint Surg Am. 1991;73:2-10.
24. Flahault A, Cadilhac M, Thomas G. Sample size calculation should be performed for design accuracy in diagnostic test studies. J Clin Epidemiol. 2005;58:859-862. http://dx.doi.org/10.1016/j.jclinepi.2004.12.009
25. Fowler PJ, Messieh SS. Isolated posterior cruciate ligament injuries in athletes. Am J Sports Med. 1987;15:553-557.
26. Grover JS, Bassett LW, Gross ML, Seeger LL, Finerman GA. Posterior cruciate ligament: MR imaging. Radiology. 1990;174:527-530.
27. Hanchard NCA, Lenza M, Handoll HHG, Takwoingi Y. Physical tests for shoulder impingements and local lesions of bursa, tendon or labrum that may accompany impingement. Cochrane Database Syst Rev. 2013;4:CD007427. http://dx.doi.org/10.1002/14651858.CD007427.pub2
28. Hardaker WT, Jr., Garrett WE, Jr., Bassett FH, 3rd. Evaluation of acute traumatic hem-arthrosis of the knee joint. South Med J. 1990;83:640-644.
29. Harilainen A. Evaluation of knee instability in acute ligamentous injuries. Ann Chir Gynaecol. 1987;76:269-273.
30. Harilainen A, Myllynen P, Rauste J, Silvennoinen E. Diagnosis of acute knee ligament injuries: the value of stress radiography compared with clinical examination, stability under anaesthesia and arthroscopic or operative findings. Ann Chir Gynaecol. 1986;75:37-43.
31. Harner CD, Höher J. Evaluation and treatment of posterior cruciate ligament injuries. Am J Sports Med. 1998;26:471-482.
32. Hegedus EJ, Goode AP, Cook CE, et al. Which physical examination tests provide clinicians with the most value when examining the shoulder? Update of a systematic review with meta-analysis of individual tests. Br J Sports Med. 2012;46:964-978. http://dx.doi.org/10.1136/bjsports-2012-091066
33. Herbert R, Jamtvedt G, Mead J, Hagen KB. Practical Evidence-Based Physiotherapy. London, UK: Elsevier; 2005.
34. Heron CW, Calvert PT. Three-dimensional gradient-echo MR imaging of the knee: comparison with arthroscopy in 100 patients. Radiology. 1992;183:839-844.
35. Hewett TE, Noyes FR, Lee MD. Diagnosis of complete and partial posterior cruciate ligament ruptures. Stress radiography compared with KT-1000 arthrometer and posterior drawer testing. Am J Sports Med. 1997;25:648-655.
36. Hochstein P, Schmickal T, Grützner PA, Wentzensen A. [Diagnostic and incidence of the rupture of the posterior cruciate ligament]. Unfallchirurg. 1999;102:753-762. http://dx.doi.org/10.1007/s001130050477
37. Hollingworth W, Medina LS, Lenkinski RE, et al. Interrater reliability in assessing quality of diagnostic accuracy studies using the QUADAS tool. A preliminary assessment. Acad Radiol. 2006;13:803-810. http://dx.doi.org/10.1016/ j.acra.2006.03.008
38. Hughston JC. The absent posterior drawer test in some acute posterior cruciate ligament tears of the knee. Am J Sports Med. 1988;16:39-43.
39. Hughston JC, Andrews JR, Cross MJ, Moschi A. Classification of knee ligament instabilities. Part I. The medial compartment and cruciate ligaments. J Bone Joint Surg Am. 1976;58:159-172.
40. Hughston JC, Andrews JR, Cross MJ, Moschi A. Classification of knee ligament instabilities. Part II. The lateral compartment. J Bone Joint Surg Am. 1976;58:173-179.
41. Hughston JC, Norwood LA, Jr. The posterolateral drawer test and external rotational recurvatum test for posterolateral rotatory instability of the knee. Clin Orthop Relat Res. 1980:82-87.
42. Jackson JL, O'Malley PG, Kroenke K. Evaluation of acute knee pain in primary care. Ann Intern Med. 2003;139:575-588.
43. Jaeschke R, Guyatt GH, Sackett DL. Users' guides to the medical literature. III. How to use an article about a diagnostic test. B. What are the results and will they help me in caring for my patients? The Evidence-Based Medicine Working Group. JAMA. 1994;271:703-707.
44. Johnson D. Posterior cruciate ligament injuries: my approach. Oper Tech Sports Med. 2009;17:167-174. http://dx.doi.org/10.1053/j.otsm.2009.06.004
45. Jung TM, Strobel MJ, Weiler A. [Diagnostics and treatment of posterior cruciate ligament injuries]. Unfallchirurg. 2006;109:41-59; quiz 60. http://dx.doi.org/10.1007/s00113-005-1040-y
46. Kastelein M, Wagemakers HP, Luijsterburg PA, Verhaar JA, Koes BW, Bierma-Zeinstra SM. Assessing medial collateral ligament knee lesions in general practice. Am J Med. 2008;121:982-988.e2. http://dx.doi.org/10.1016/j.amjmed. 2008.05.041
47. Khanda GE, Akhtar W, Ahsan H, Ahmad N. Assessment of menisci and ligamentous injuries of the knee on magnetic resonance imaging: correlation with arthroscopy. J Pak Med Assoc. 2008;58:537-540.
48. Knottnerus JA, Muris JW. Assessment of the accuracy of diagnostic tests: the cross-sectional study. J Clin Epidemiol. 2003;56:1118-1128.
49. Knottnerus JA, van Weel C, Muris JW. Evaluation of diagnostic procedures. BMJ. 2002;324:477-480.
50. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159-174.
51. LaPrade RF, Terry GC. Injuries to the posterolateral aspect of the knee. Association of anatomic injury patterns with clinical instability. Am J Sports Med. 1997;25:433-438.
52. LaPrade RF, Wentorf F. Diagnosis and treatment of posterolateral knee injuries. Clin Orthop Relat Res. 2002:110-121.
53. Larsen MW, Toth A. Examination of posterolateral corner injuries. J Knee Surg. 2005;18:146-150.
54. Larson RL. Physical examination in the diagnosis of rotatory instability. Clin Orthop Relat Res. 1983:38-44.
55. Lee BK, Nam SW. Rupture of posterior cruciate ligament: diagnosis and treatment principles. Knee Surg Relat Res. 2011;23:135-141. http://dx.doi.org/ 10.5792/ksrr.2011.23.3.135
56. Leeflang MM, Bossuyt PM, Irwig L. Diagnostic test accuracy may vary with prevalence: implications for evidence-based diagnosis. J Clin Epidemiol. 2009;62:5-12. http://dx.doi.org/10.1016/j.jclinepi.2008.04.007
57. Leeflang MM, Deeks JJ, Gatsonis C, Bossuyt PM. Systematic reviews of diagnostic test accuracy. Ann Intern Med. 2008;149:889-897.
58. Lobenhoffer P, Lattermann C, Krettek C, Blauth M, Tscherne H. [Rupture of the posterior cruciate ligament: status of current treatment]. Unfallchirurg. 1996;99:382-399.
59. Lokannavar HS, Yang X, Guduru H. Arthroscopic and low-field MRI (0.25 T) evaluation of meniscus and ligaments of painful knee. J Clin Imaging Sci. 2012;2:24. http://dx.doi.org/10.4103/2156-7514.96539
60. Loomer RL. A test for knee posterolateral rotatory instability. Clin Orthop Relat Res. 1991:235-238.
61. Loos WC, Fox JM, Blazina ME, Del Pizzo W, Friedman MJ. Acute posterior cruciate ligament injuries. Am J Sports Med. 1981;9:86-92.
62. Lubowitz JH, Bernardini BJ, Reid JB, 3rd. Current concepts review: comprehensive physical examination for instability of the knee. Am J Sports Med. 2008;36:577-594. http://dx.doi.org/10.1177/0363546507312641
63. Malanga GA, Andrus S, Nadler SF, McLean J. Physical examination of the knee: a review of the original test description and scientific validity of common orthopedic tests. Arch Phys Med Rehabil. 2003;84:592-603. http://dx.doi.org/10.1053/apmr.2003.50026
64. Margheritini F, Mancini L, Mauro CS, Mariani PP. Stress radiography for quantifying posterior cruciate ligament deficiency. Arthroscopy. 2003;19:706-711.
65. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol. 2009;62:1006-1012. http://dx.doi.org/10.1016/j.jclinepi.2009.06.005
66. Mol BW, Lijmer JG, Evers JL, Bossuyt PM. Characteristics of good diagnostic studies. Semin Reprod Med. 2003;21:17-25. http://dx.doi.org/10.1055/ s-2003-39991
67. Moore HA, Larson RL. Posterior cruciate ligament injuries. Results of early surgical repair. Am J Sports Med. 1980;8:68-78.
68. MP field in Ovid databases. Available at: http://ovidsupport.custhelp. com/app/answers/detail/a-id/1393/~/.mp-field-in-ovid-databases. Accessed July 27, 2012.
69. Neumann A, Schiller K, Witt S, Betz A, Krueger P, Schweiberer L. [Knee joint hemarthrosis. An absolute indication for operation?]. Unfallchirurg. 1991;94:560-564.
70. Nikolaou VS, Chronopoulos E, Savvidou C, et al. MRI efficacy in diagnosing internal lesions of the knee: a retrospective analysis. J Trauma Manag Outcomes. 2008;2:4. http://dx.doi.org/10.1186/1752-2897-2-4
71. O'Shea KJ, Murphy KP, Heekin RD, Herzwurm PJ. The diagnostic accuracy of history, physical examination, and radiographs in the evaluation of traumatic knee disorders. Am J Sports Med. 1996;24:164-167.
72. Owens TC. Posteromedial pivot shift of the knee: a new test for rupture of the posterior cruciate ligament. A demonstration in six patients and a study of anatomical specimens. J Bone Joint Surg Am. 1994;76:532-539.
73. Reitsma JB, Rutjes AWS, Whiting P, Vlassov VV, Leeflang MMG, Deeks JJ. Chapter 9: assessing methodological quality. In: Deeks JJ, Bossuyt PM, Gatsonis C, eds. Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy Version 1.0.0. Oxford, UK: The Cochrane Collaboration; 2009.
74. Rubinstein RA, Jr., Shelbourne KD, McCarroll JR, VanMeter CD, Rettig AC. The accuracy of the clinical examination in the setting of posterior cruciate ligament injuries. Am J Sports Med. 1994;22:550-557.
75. Rutjes AW, Reitsma JB, Di Nisio M, Smidt N, van Rijn JC, Bossuyt PM. Evidence of bias and variation in diagnostic accuracy studies. CMAJ. 2006;174:469-476. http://dx.doi.org/10.1503/cmaj.050090
76. Rutjes AW, Reitsma JB, Vandenbroucke JP, Glas AS, Bossuyt PM. Case-control and two-gate designs in diagnostic accuracy studies. Clin Chem. 2005;51:1335-1341. http://dx.doi.org/10.1373/clinchem.2005.048595
77. Sandberg R, Balkfors B, Henricson A, Westlin N. Stability tests in knee ligament injuries. Arch Orthop Trauma Surg. 1986;106:5-7. http://dx.doi.org/10. 1007/BF00435642
78. Schneiders AG, Sullivan SJ, Hendrick PA, et al. The ability of clinical tests to diagnose stress fractures: a systematic review and meta-analysis. J Orthop Sports Phys Ther. 2012;42:760-771. http://dx.doi.org/10.2519/jospt.2012. 4000
79. Schulz MS, Russe K, Weiler A, Eichhorn HJ, Strobel MJ. Epidemiology of posterior cruciate ligament injuries. Arch Orthop Trauma Surg. 2003;123:186-191. http://dx.doi.org/10.1007/s00402-002-0471-y
80. Shelbourne KD, Davis TJ, Patel DV. The natural history of acute, isolated, nonoperatively treated posterior cruciate ligament injuries. A prospective study. Am J Sports Med. 1999;27:276-283.
81. Simonsen O, Jensen J, Mouritsen P, Lauritzen J. The accuracy of clinical examination of injury of the knee joint. Injury. 1984;16:96-101.
82. Solomon DH, Simel DL, Bates DW, Katz JN, Schaffer JL. The rational clinical examination. Does this patient have a torn meniscus or ligament of the knee? Value of the physical exami-nation. JAMA. 2001;286:1610-1620.
83. Staubli HU, Jakob RP. Posterior instability of the knee near extension. A clinical and stress radiographic analysis of acute injuries of the posterior cruciate ligament. J Bone Joint Surg Br. 1990;72:225-230.
84. Strobel MJ, Weiler A, Schulz MS, Russe K, Eichhorn HJ. Fixed posterior subluxation in posterior cruciate ligament-deficient knees: diagnosis and treatment of a new clinical sign. Am J Sports Med. 2002;30:32-38.
85. van Eck CF, van den Bekerom MP, Fu FH, Poolman RW, Kerkhoffs GM. Methods to diagnose acute anterior cruciate ligament rupture: a meta-analysis of physical examinations with and without anaesthesia. Knee Surg Sports Traumatol Arthrosc. 2013;21:1895-1903. http://dx.doi.org/10.1007/s00167-012-2250-9
86. Vaz CE, Camargo OP, Santana PJ, Valezi AC. Accuracy of magnetic resonance in identifying traumatic intraarticular knee lesions. Clinics (São Paulo). 2005;60:445-450. http://dx.doi.org/10.1590/S1807-59322005000600003
87. Whiting P, Harbord R, Kleijnen J. No role for quality scores in systematic reviews of diagnostic accuracy studies. BMC Med Res Methodol. 2005;5:19. http://dx.doi.org/10.1186/1471-2288-5-19
88. Whiting P, Rutjes AW, Reitsma JB, Bossuyt PM, Kleijnen J. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol. 2003;3:25. http://dx.doi.org/10.1186/1471-2288-3-25
89. Whiting P, Westwood M, Burke M, Sterne J, Glanville J. Systematic reviews of test accuracy should search a range of databases to identify primary studies. J Clin Epidemiol. 2008;61:357.e1-357.e10. http://dx.doi.org/10.1016/j. jclinepi.2007.05.013
90. Whiting PF, Rutjes AW, Westwood ME, et al. QUADAS-2: a revised tool for the quality as-sessment of diagnostic accuracy studies. Ann Intern Med. 2011;155:529-536. http://dx.doi.org/10.7326/0003-4819-155-8-201110180-00009
91. Whiting PF, Weswood ME, Rutjes AW, Reitsma JB, Bossuyt PN, Kleijnen J. Evaluation of QUADAS, a tool for the quality assessment of diagnostic accuracy studies. BMC Med Res Methodol. 2006;6:9. http://dx.doi.org/10.1186/1471-2288-6-9
92. Wind WM, Jr., Bergfeld JA, Parker RD. Evaluation and treatment of posterior cruciate ligament injuries: revisited. Am J Sports Med. 2004;32:1765-1775. http://dx.doi.org/10.1177/0363546504270481
93. Wissing H, Schmuelling F. Pattern of lesions and operative treatment in recent injuries to the ligaments of the knee. Zentralbl Chir. 1980;105:350.