文献简介

出版社:J. SHEN ET AL.

作  者:Jiewei Shen,Hui Zhang,Yanwei Lv,Lei Hong,Xuesong Wang,Jin Zhang,Hua Feng

编  号:doi.org/10.1016/j.arthro.2012.10.031

关键字:Validity,Novel Arthroscopic Test,Diagnose Posterolateral

年  份:2012   点击量:3298

文献摘要

Purpose:
    The purpose of this study was to assess the validity of a newly developed arthroscopic test, termed the lateral gutter drive-through (LGDT) test, to diagnose posterolateral rotational instability (PLRI) of the knee joint.
Methods:
    Between October 2009 and February 2012, 115 consecutive patients were enrolled into this prospective diagnostic study. The dial test was used as the gold standard for diagnostic reference. According to the dial test,  the patients were divided into a study group (35 patients) and a control group (80 patients). The LGDT test was performed  on all patients during arthroscopic surgery. The sensitivity and specificity of the LGDT test were calculated. Sensitivities  were also calculated in subgroups defined by injury patterns and extents of tibial external rotational instability. 
Results:
    The sensitivity and specificity of the LGDT test were calculated as 91.4% and 93.8%, respectively. In subgroup  analyses the sensitivity of detection for acute PLRI was 90% versus 92% in chronic cases (P ¼ .849). Popliteus femoral  “peel-off” lesions were detected with a sensitivity of 100% versus 87.0% in cases of nonepeel-off lesions (P ¼ .536). The  sensitivity of detecting isolated external rotational instability versus combined instability (rotational and varus) was 90.5%  versus 92.8% (P ¼ .805). The sensitivity of the LGDT test was correlated with the extent of tibial external rotational  instability (P < .001).
Conclusions:
    This study showed that the LGDT test is a reliable method and can be used for diagnosing PLRI of the knee joint. The highest sensitivity was observed in patients with the femoral peel-off injury pattern. The  sensitivity of the LGDT test was correlated with the extent of tibial external rotational instability and was significantly higher  in patients with an increase in tibial external rotation by more than 10.