Anterior Cruciate Ligament Tear: Sensitivity and Specificity

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

Systematic review. Radiology 2003 PMID: 12601211

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

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

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