title: Clinical assessment of antero-medial rotational knee laxity: a systematic review.
abstract: OBJECTIVE
  To inventory the examination methods available to assess antero-medial rotational laxity (AMRL) of the knee following medial collateral ligament injury.
  
  
  METHODS
  Searches were conducted in accordance with the PRISMA guidelines and using four online databases: WEB OF SCIENCE, MEDLINE, EMBASE, and AMED. The Critical Appraisal Skills Programme guidelines for Diagnostic Test Studies were used for the quality assessment of the articles.
  
  
  RESULTS
  A total of 2241 articles were identified from the database searches. From this, four articles were included in the final review. All were case-control studies, considered a combined ACL/MCL injury and had small study populations. Specialised equipment was required in all studies, and one needed additional imaging support before measurements could be taken. Two employed commercially available measuring equipment as part of the assessment process.
  
  
  CONCLUSIONS
  Clinical assessment of AMRL in relation to a MCL injury remains challenging. Although methods have been developed to support clinical examination, they are limited by a number of factors, including the need for additional time in the clinical environment when setting up equipment, the need for specific equipment to produce and measure rotational movement and imaging support. In addition, there are patient safety concerns from the repeated imaging. A reliable and valid clinical examination remains to be found to truly assess antero-medial rotational laxity of the knee.
  
  
  METHODS
  IV.
authors: Institute for Sport, Exercise and Health, University College London, London, UK. dinesh.sirisena@alexandrahealth.com.sg.|Khoo Teck Puat Hospital, 90 Yishun Central, Yishun, 768828, Singapore. dinesh.sirisena@alexandrahealth.com.sg.
authors: Dinesh
authors: D
authors: Sirisena
authors: Department of Surgery and Cancer, Imperial College London, London, UK.
authors: Enrica
authors: E
authors: Papi
authors: Institute for Sport, Exercise and Health, University College London, London, UK.
authors: Eleanor
authors: E
authors: Tillett
mesh_terms: D053587:Arthrometry, Articular / Q000295:instrumentation*; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis* / Q000503:physiopathology; D007719:Knee Joint / Q000503:physiopathology*; D017888:Medial Collateral Ligament, Knee / Q000293:injuries*; D010808:Physical Examination / Q000295:instrumentation / Q000379:methods
keywords: Clinical examination; Deep medial collateral ligament; Knee injury; Knee stability; Medial collateral ligament; Rotational laxity