Anterior Cruciate Ligament Tear: Sensitivity and Specificity

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The sensitivity and specificity of findings for Anterior Cruciate Ligament Tear are listed below. See the left navigation bar to change the display.

Sensitive and Specific Findings

Lachman Test

87%

93%

pull anteriorly when knee is flexed at 30 degrees

Study: Ann Intern Med. 2003 Oct 7;139(7):575-88. PMID: 14530229

MRI

87%

91%

Study: Ann Intern Med. 2003 Oct 7;139(7):575-88. PMID: 14530229

Systematic review. Radiology 2003 PMID: 12601211

Specific Findings

Finding	Sensitivity	Specificity	Comments, Study
Pivot Test	61%	97%	Fully extend the knee, rotate the foot internally. Apply a valgus stress while progressively flexing the knee, watching and feeling for translation of the tibia on the femur. Study: Ann Intern Med. 2003 Oct 7;139(7):575-88. PMID: 14530229
Anterior drawer test as measured by the KT-1000 arthrometer	77%	90%	The sensitivity and specificity will vary based on the amount of force applied and the threshold chosen for anterior tibial motion. These numbers above are for a 30 lbs test with >3mm as diagnostic threshold for ACL tear. Study: PMID 19398799
Anterior Drawer Test	48%	87%	pull anteriorly when the knee is flexed at 90 degrees Note that when the anterior drawer test has been studied using the KT-1000 arthrometer. This provides an objective measure to the anterior drawer test. When performed with the KT-1000 arthrometer, the sensitivity and specificity will vary based on the amount of force applied and the threshold chosen for anterior tibial motion. For a 30 lbs test with >3mm as diagnostic threshold for ACL tear the sensitivity and specificity have been reported as 77% and 90%. The anterior drawer test has been studied with objective measurements using ultrasonography. The sensitivity and specificity were reported as 96% and 98% though the cut off displacement distance appears to have been decided upon after the data was examied. See PMID 10401653 Study: Anterior drawer test: Ann Intern Med. 2003 Oct 7;139(7):575-88. PMID: 14530229 KT-1000 Arthrometer: PMID 19398799 Ultrasound: PMID 10401653