Diagnostic validity of physical examination tests for common knee disorders: An overview of systematic reviews and meta-analysis

被引：28
作者：
Decary, Simon [1 ,2 ]
Ouellet, Philippe [1 ,2 ]
Vendittoli, Pascal-Andre [2 ,3 ]
Roy, Jean-Sebastien [4 ,5 ,6 ]
Desmeules, Francois [1 ,2 ]
机构：
[1] Univ Montreal, Fac Med, Sch Rehabil, Montreal, PQ, Canada
[2] Univ Montreal, Affiliated Res Ctr, Maisonneuve Rosemont Hosp, Orthopaed Clin Res Unit,Res Ctr, Montreal, PQ, Canada
[3] Univ Montreal, Maisonneuve Rosemont Hosp, Dept Surg, Montreal, PQ, Canada
[4] Univ Laval, Fac Med, Dept Rehabil, Quebec City, PQ, Canada
[5] Ctr Interdisciplinary Res Rehabil, Quebec City, PQ, Canada
[6] Ctr Social Integrat, Quebec City, PQ, Canada
来源：
PHYSICAL THERAPY IN SPORT | 2017年 / 23卷
关键词：
Knee; Validity; Physical examination tests; Diagnostic; ANTERIOR CRUCIATE LIGAMENT; PATELLOFEMORAL PAIN SYNDROME; CLINICAL DECISION RULES; QUALITY-OF-LIFE; MEASUREMENT TOOL; METHODOLOGICAL QUALITY; GENERAL-POPULATION; MENISCAL TEARS; TORN MENISCUS; ACCURACY;
D O I：
10.1016/j.ptsp.2016.08.002
中图分类号：
R49 [康复医学];
学科分类号：
100215 ;
摘要：
Introduction: More evidence on diagnostic validity of physical examination tests for knee disorders is needed to lower frequently used and costly imaging tests. Objective: To conduct a systematic review of systematic reviews (SR) and meta-analyses (MA) evaluating the diagnostic validity of physical examination tests for knee disorders. Methods: A structured literature search was conducted in five databases until January 2016. Methodological quality was assessed using the AMSTAR. Results: Seventeen reviews were included with mean AMSTAR score of 5.5 +/- 2.3. Based on six SR, only the Lachman test for ACL injuries is diagnostically valid when individually performed (Likelihood ratio (LR+):10.2, LR-:0.2). Based on two SR, the Ottawa Knee Rule is a valid screening tool for knee fractures (LR-:0.05). Based on one SR, the EULAR criteria had a post-test probability of 99% for the diagnosis of knee osteoarthritis. Based on two SR, a complete physical examination performed by a trained health provider was found to be diagnostically valid for ACL, pg.. and meniscal injuries as well as for cartilage lesions. Conclusion: When individually performed, common physical tests are rarely able to rule in or rule out a specific knee disorder, except the Lachman for ACL injuries. There is low-quality evidence concerning the validity of combining history elements and physical tests. (C) 2016 Elsevier Ltd. All rights reserved.
引用
收藏
页码：143 / 155
页数：13
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