title: Physical examination tests for the diagnosis of posterior cruciate ligament rupture: a systematic review.
abstract: METHODS
  Systematic literature review.
  
  
  OBJECTIVE
  To summarize and evaluate research on the accuracy of physical examination tests for diagnosis of posterior cruciate ligament (PCL) tear.
  
  
  BACKGROUND
  Rupture of the PCL is a severe knee injury that can lead to delayed rehabilitation, instability, or chronic knee pathologies. To our knowledge, there is currently no systematic review of studies on the diagnostic accuracy of clinical examination tests to evaluate the integrity of the PCL.
  
  
  METHODS
  A comprehensive systematic literature search was conducted in MEDLINE from 1946, Embase from 1974, and the Allied and Complementary Medicine Database from 1985 until April 30, 2012. Studies were considered eligible if they compared the results of physical examination tests performed in the context of a PCL physical examination to those of a reference standard (arthroscopy, arthrotomy, magnetic resonance imaging). Methodological quality assessment was performed by 2 independent reviewers using the revised version of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool.
  
  
  RESULTS
  The search strategy revealed 1307 articles, of which 11 met the inclusion criteria for this review. In these studies, 11 different physical examination tests were identified. Due to differences in study types, different patient populations, and methodological quality, meta-analysis was not indicated. Presently, most physical examination tests have not been evaluated sufficiently enough to be confident in their ability to either confirm or rule out a PCL tear.
  
  
  CONCLUSIONS
  The diagnostic accuracy of physical examination tests to assess the integrity of the PCL is largely unknown. There is a strong need for further research in this area. Level of Evidence Diagnosis, level 3a.
authors.affiliation: Centre for Evidence-Based Healthcare, University Hospital Carl Gustav Carus Dresden, Dresden, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Kopkow
authors.forename: Alice
authors.initials: A
authors.lastname: Freiberg
authors.forename: Stephan
authors.initials: S
authors.lastname: Kirschner
authors.forename: Andreas
authors.initials: A
authors.lastname: Seidler
authors.forename: Jochen
authors.initials: J
authors.lastname: Schmitt
mesh_terms: D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis*; D010808:Physical Examination; D016119:Posterior Cruciate Ligament / Q000293:injuries*