Meniscal Lesions in the Anterior Cruciate Insufficient Knee: the Accuracy of Clinical Evaluation
Chathchai Pookarnjanamorakot MD*, Thongchai Korsantirat MD**, Patarawan Woratanarat MD*
Affiliation : * Department of Orthopaedics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University ** Department of Orthopaedics, Faculty of Medicine, Srinakharinwirot University
Objective : The purpose of this study was to find out the accuracy of certain symptoms and examination
findings that are used to diagnose meniscal injury associated with a torn anterior cruciate ligament.
Study
Design : Cross-sectional study.
Materials and Methods : The authors studied one hundred consecutive patients with anterior cruciate
ligament insufficiency who were scheduled for surgery. During preoperative admission, one of the authors
(KT) examined the patients and recorded the demographic data, duration of symptoms, and the clinical
findings including Ballottement sign, joint line tenderness, Childress’ sign, Merke’s sign, Steinmann I sign,
Mc Murray test, and Apley test. All patients underwent arthroscopically assisted anterior cruciate
reconstruction by the senior author (PC). Specific meniscal procedures were performed according to the
surgeon’s preference at the time of surgery. Predictive results of preoperative examination tests for meniscal
tears were compared with the findings at surgery and analyzed using arthroscopic findings as the gold
standard.
Results : There were one hundred patients included in the present study. Out of 100 patients, 75% had
meniscal tears and 6% had both meniscal and cartilage lesions. The most sensitive test was Childress’ sign
(68%), which also had the highest accuracy (66%). The most specific tests were Steinmann I sign and Apley
test (100%).
Conclusion : Childress’ sign was more accurate than other tests for detecting meniscal lesions in anterior
cruciate insufficient knees. Steinmann I sign and Apley test had the highest specificity.
Keywords : Meniscus lesions, Anterior cruciate ligament, Childress’ sign, Steinmann I test, Apley test
