ArticleThe Iowa orthopaedic journal2024
The Albright-Losee Low Profile Pivot Shift Test for ACL Deficiency.
Article in The Iowa orthopaedic journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Recognizing ACL injuries on the field and in the office can be very challenging in awake and apprehensive patients. Despite high specificity, many published "pivot-shift" techniques have limited acceptance mainly because of unsatisfactory sensitivity. We describe in detail, four specific modifications and provide a critical review of our clinical experiences to empower the new user's readiness to master a novel screening procedure for ACL disruption. Methods: 18 cadavers assessed instability kinematics of the novel technique. Clinical Exam Study Part II-A (ACL Disrupted): 208 awake, hemarthrosis patients with MRI evidence of ACL deficiency underwent 363 examinations by 41 examiners. Clinical Exam Study Part II-B: (ACL Intact) 47 consecutive posttraumatic hemarthrosis patients with intact ACLs underwent 76 examinations by 30 examiners. Results: Cadaveric study confirmed patterns of coupled, anterior translation-internal rotation pathologic laxity at 25.6±8.2 degrees flexion. Clinically, the novel test yielded sensitivity of 94.7% and Specificity of 97.3%. Potentially perplexing situations included: MRI availability; pain and anxiety-related traumatic hemarthrosis, protective hamstring antagonism and examiners experience. Conclusion: When the examiner and patient agree on a feeling of instability, the Albright-Losee Test maximizes ability to establish ACL status in the awake patient to the point that the sensitivity is even greater than the Lachman Test. Armed with background knowledge of our experiences confirms that, despite of impact of various challenging factors, the Positive Predictive Value 98.8% 95% CI (95.5%-99.7%) that a torn ACL exists in face of a positive exam confirms its value for sports medicine providers to master.
Indexed as
Identifiers
39811160PMC11726477What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.