Meniscal lesions in the anterior cruciate insufficient knee: the accuracy of clinical evaluation.
OBJECTIVE
The purpose of this study was to find out the accuracy of certain symptoms and examination findings that are used to diagnose meniscal injury associated with a torn anterior cruciate ligament.


METHODS
Cross-sectional study.


METHODS
The authors studied one hundred consecutive patients with anterior cruciate ligament insufficiency who were scheduled for surgery. During preoperative admission, one of the authors (KT) examined the patients and recorded the demographic data, duration of symptoms, and the clinical findings including Ballottement sign, joint line tenderness, Childress' sign, Merke's sign, Steinmann I sign, McMurray test, and Apley test. All patients underwent arthroscopically assisted anterior cruciate reconstruction by the senior author (PC). Specific meniscal procedures were performed according to the surgeon's preference at the time of surgery. Predictive results of preoperative examination tests for meniscal tears were compared with the findings at surgery and analyzed using arthroscopic findings as the gold standard.


RESULTS
There were one hundred patients included in the present study. Out of 100 patients, 75% had meniscal tears and 6% had both meniscal and cartilage lesions. The most sensitive test was Childress' sign (68%), which also had the highest accuracy (66%). The most specific tests were Steinmann I sign and Apley test (100%).


CONCLUSIONS
Childress' sign was more accurate than other tests for detecting meniscal lesions in anterior cruciate insufficient knees. Steinmann I sign and Apley test had the highest specificity.
Department of Orthopaedics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. racpk@mahidol.ac.th
Chathchai
C
Pookarnjanamorakot
Thongchai
T
Korsantirat
Patarawan
P
Woratanarat
D000293:Adolescent; D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D000070600:Tibial Meniscus Injuries