LEVER SIGN TEST FOR CHRONIC ACL INJURY: A COMPARISON WITH LACHMAN AND ANTERIOR DRAWER TESTS

LEVER SIGN TEST FOR CHRONIC ACL INJURY: A COMPARISON WITH LACHMAN AND ANTERIOR DRAWER TESTS

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ABSTRACT Objective: This study aims to evaluate the sensitivity and specificity of the lever sign test in patients with and without chronic Equine - Grooming - Bathing Products - Shampoo Anterior Cruciate Ligament (ACL) injuries in an outpatient setting and the inter-examiner agreement of surgeons with different levels of experience.Methods: 72 consecutive patients with a history of previous knee sprains were included.The Lachman, anterior drawer, and Lever Sign tests were performed for all subjects in a randomized order by three blinded raters with different levels of experience.

Sensitivity, specificity, positive predictive value, negative predictive value, and inter-rater agreement were estimated for all tests.Results: Among the 72 patients, the prevalence of ACL injuries was 54%.The lever test showed sensitivity of 64.

1% (95% CI 0.47-0.78) and specificity Buttons/Pins of 100% (95% CI 0.

87-1.00) for the senior examiner.For the less experienced examiner the sensitivity was 51.

8% and the specificity was 93.7%.Positive predictive values (PPV) and negative predictive values (NPV) were 100% and 70.

2%, respectively.Conclusion: Lever Sign test shows to be a maneuver of easy execution, with 100% specificity and 100% PPV.Moderate agreement between experienced examiners and low agreement among experienced and inexperienced examiners was found.

This test may play a role as an auxiliary maneuver.Level of Evidence I, Diagnostic Studies - Investigating a Diagnostic Test.