Abstract
The aim of this trial was to assess the clinical examination findings commonly used for the ACL deficient knee.
For reliability testing and criterion validation 102 patients with ACL injuries were assessed by a single observer, 35 by a second observer and 47 again by the initial observer. For construct and criterion validation 30 patients were assessed pre-operatively and a mean of 1.7 years after ACL reconstruction. The Lysholm 11, Tegner and Cincinnati outcome measures were assessed along with instrumented knee laxity (Stryker test), the one hop test (OHT) and graded tests (including anterior draw, Lachman test, quality of end point, and pivot shift test).
The outcome measures were found to be reliable except the Cincinnati system. All examination findings were of unsatisfactory reliability, with the exception of the OHT and the Stryker test. Construct validation revealed a significant improvement in all outcome measure scores and examination findings following ACL reconstruction. Criterion validation revealed that of the examination findings only the OHT had a satisfactory correlation with the symptom of giving way and the Lysholm/Tegner measures. Comparison of the difference between the desired and actual Tegner activity levels with the examination findings revealed an improvement in all levels of correlation.
With the exception of the OHT, the clinical examination findings used for the ACL deficient knee are unreliable and correlate poorly with the functional outcome of the patient. They may, however, have some benefit in assessment of deficiency of the anatomical structures and the findings should be presented individually, rather than forming part of the functional assessment of the patient.
The abstracts were prepared by Mr R. B. Smith. Correspondence should be addressed to him at the British Orthopaedic Association, Royal College of Surgeons, 35-43 Lincoln’s Inn Fields, London WC2A 3PN.
