title: Reliability of physical examination tests for the diagnosis of knee disorders: Evidence from a systematic review.
abstract: Clinicians often rely on physical examination tests to guide them in the diagnostic process of knee disorders. However, reliability of these tests is often overlooked and may influence the consistency of results and overall diagnostic validity. Therefore, the objective of this study was to systematically review evidence on the reliability of physical examination tests for the diagnosis of knee disorders. A structured literature search was conducted in databases up to January 2016. Included studies needed to report reliability measures of at least one physical test for any knee disorder. Methodological quality was evaluated using the QAREL checklist. A qualitative synthesis of the evidence was performed. Thirty-three studies were included with a mean QAREL score of 5.5 ± 0.5. Based on low to moderate quality evidence, the Thessaly test for meniscal injuries reached moderate inter-rater reliability (k = 0.54). Based on moderate to excellent quality evidence, the Lachman for anterior cruciate ligament injuries reached moderate to excellent inter-rater reliability (k = 0.42 to 0.81). Based on low to moderate quality evidence, the Tibiofemoral Crepitus, Joint Line and Patellofemoral Pain/Tenderness, Bony Enlargement and Joint Pain on Movement tests for knee osteoarthritis reached fair to excellent inter-rater reliability (k = 0.29 to 0.93). Based on low to moderate quality evidence, the Lateral Glide, Lateral Tilt, Lateral Pull and Quality of Movement tests for patellofemoral pain reached moderate to good inter-rater reliability (k = 0.49 to 0.73). Many physical tests appear to reach good inter-rater reliability, but this is based on low-quality and conflicting evidence. High-quality research is required to evaluate the reliability of knee physical examination tests.
authors.affiliation: School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada; Maisonneuve-Rosemont Hospital Research Center, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada. Electronic address: simon.decary.1@umontreal.ca.
authors.forename: Simon
authors.initials: S
authors.lastname: Décary
authors.affiliation: School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada; Maisonneuve-Rosemont Hospital Research Center, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada. Electronic address: philippe.ouellet.3@umontreal.ca.
authors.forename: Philippe
authors.initials: P
authors.lastname: Ouellet
authors.affiliation: Maisonneuve-Rosemont Hospital Research Center, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada; Department of Surgery, Maisonneuve-Rosemont Hospital, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, University of Montreal Affiliated Hospital, Montreal, Quebec, Canada. Electronic address: pa.vendittoli@me.com.
authors.forename: Pascal-André
authors.initials: PA
authors.lastname: Vendittoli
authors.affiliation: School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada; Maisonneuve-Rosemont Hospital Research Center, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada. Electronic address: f.desmeules@umontreal.ca.
authors.forename: François
authors.initials: F
authors.lastname: Desmeules
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019937:Diagnostic Techniques and Procedures / Q000592:standards*; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D010808:Physical Examination / Q000592:standards*; D015203:Reproducibility of Results
keywords: Knee; Physical examination tests; Reliability