METHODS: PRISMA guidelines were followed, studies were identified using PubMed, EMBASE and Google Scholar. All studies that reported accuracy of LST performed by a clinical professional were included. Integrity of ACL was confirmed using magnetic resonance imaging or arthroscopy. Sensitivity and specificity were calculated using uni- and bivariate methods.
RESULTS: After inclusion, 3299 observations in 2516 patients were included from 23 studies. Mean age was 31.8 years and 64.2% were male. Without anesthesia, sensitivity was 79.2% (95% CI 68.7-86.9) and specificity was 92.0% (95% CI 82.2-96.6). An area under the curve (AUC) of 86.1% was found. With anesthesia, sensitivity was 86.6% (95% CI 68.0-95.2), specificity was 93.4% (95% CI 84.5-97.3) and the AUC was 91.6%.
CONCLUSIONS: The Lever Sign test shows very good to excellent accuracy for ACL injury, and is a useful tool for clinical practice.
方法:遵循PRISMA指南,研究是使用PubMed确定的,EMBASE和谷歌学者。包括所有报告由临床专业人员进行的LST准确性的研究。使用磁共振成像或关节镜检查确认ACL的完整性。使用单变量和双变量方法计算敏感性和特异性。
结果:纳入后,从23项研究中纳入了2516例患者的3299观察结果。平均年龄为31.8岁,男性占64.2%。没有麻醉,敏感性为79.2%(95%CI68.7~86.9),特异性为92.0%(95%CI82.2~96.6).发现曲线下面积(AUC)为86.1%。用麻醉,灵敏度为86.6%(95%CI68.0-95.2),特异性为93.4%(95%CI84.5-97.3),AUC为91.6%.
结论:杠杆符号测试表明ACL损伤的准确性非常好,是临床实践的有用工具。