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CC BY 4.0 · Rev Bras Ortop (Sao Paulo) 2025; 60(05): s00451813005
DOI: 10.1055/s-0045-1813005
Original Article

Value of Clinical Tests in Diagnosing Anterior Cruciate Ligament Tears: What Is New?

Valor dos exames clínicos para o diagnóstico de rupturas do ligamento cruzado anterior: O que há de novo?

Authors

  • Long Thanh Nguyen 

    1   Department of Surgery, Danang Hospital, Danang, Vietnam

  • Son Van Truong

    1   Department of Surgery, Danang Hospital, Danang, Vietnam

  • Uyen Thi Phuong Nguyen

    2   Department of Radiology, Vinhduc Hospital, Quangnam, Vietnam

Financial Support The authors declare that they did not receive financial support from agencies in the public, commercial, or nonprofit sectors to conduct the present study.
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Abstract

Objective

To investigate the value of clinical diagnostic tests for diagnosing anterior cruciate ligament (ACL) tears with the anterior drawer, Lachman, Pivot-shift, lever sign, and Forced Active Buckling (FAB)-sign tests.

Methods

A cross-sectional study was conducted on 165 knee injury patients who were indicated for knee arthroscopy from January to December 2022. The clinical examination results were compared with the procedure's gold standard to determine the value of clinical diagnostic tests.

Results

The sensitivity and specificity values, respectively, were anterior drawer test: 77.5% and 86.1%; Lachman: 87.6% and 88.9%; Pivot-shift: 65.9% and 94.4%; Lever sign: 93.8% and 94.4%; and FAB sign: 81.4% and 97.2%.

Conclusion

There are various clinical diagnostic tests for ACL tears. The Lever sign is a useful clinical test for physicians to examine and diagnose this condition.

Resumo

Objetivo

Investigar o valor dos exames clínicos para diagnóstico de rupturas do ligamento cruzado anterior (LCA) com os testes da gaveta anterior, Lachman, pivot-shift, sinal de alavanca e sinal de flambagem ativa forçada (FAB, do inglês forced active buckling).

Métodos

Este estudo transversal foi conduzido com 165 pacientes com lesão no joelho e indicação para artroscopia, entre janeiro e dezembro de 2022. Os resultados dos exames clínicos foram comparados ao padrão-ouro do procedimento para determinar o valor dos testes diagnósticos.

Resultados

Os valores de sensibilidade e especificidade foram, respectivamente: teste da gaveta anterior: 77,5% e 86,1%; Lachman: 87,6% e 88,9%; pivot-shift: 65,9% e 94,4%; sinal de alavanca: 93,8% e 94,4%; e sinal de FAB: 81,4% e 97,2%.

Conclusão

Há diversos exames clínicos para rupturas do LCA. O sinal da alavanca é um teste clínico útil para exame e diagnóstico dessa condição.

Keywords

anterior cruciate ligament injuries - knee injuries - meniscus - rupture

Palavras-chave

lesões do ligamento cruzado anterior - lesões do joelho - menisco - ruptura

Work developed at the Department of Surgery, Danang Hospital, Danang, Vietnam.




Publication History

Received: 17 October 2023

Accepted: 18 September 2025

Article published online:
10 December 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Long Thanh Nguyen, Son Van Truong, Uyen Thi Phuong Nguyen. Value of Clinical Tests in Diagnosing Anterior Cruciate Ligament Tears: What Is New?. Rev Bras Ortop (Sao Paulo) 2025; 60: s00451813005.
DOI: 10.1055/s-0045-1813005