Abstract

Although anterior cruciate ligament injury is diagnosed clinically, various clinical tests are performed to diagnosed ACL injury but lever sign test has proved superior to the other manual tests, being equally definitive for partial as well as complete tears and additionally being diagnostic even for acute injuries. Objective of the study is to determine the diagnostic accuracy of Lelli test (lever sign test) for diagnosis of anterior cruciate ligament tear taking arthroscopy as gold standard./p>

Material and methods:This cross section validation study was conducted in department of orthopedics, Hayatabad Medical Complex Peshawar, Pakistan from Jan 2020 to Jan 2022. A total of 254 patients with knee injuries were included in the study. Results of lelli’s test (positive/negative) and arthroscopy were recorded.

Results: Mean age was 32.543±6.53 years, age range was 18 to 50 years and mean duration of injury was 18.36±9.61 days. Lelli’s test was positive for ACL injury in 110(43.3%) patients while arthroscopically 101(39.8%) patients were confirmed for ACL injury. Lelli’s test has shown sensitivity of 91.1%, specificity of 88.2% and diagnostic accuracy of 89%, PPV 83.6% and NPV of 93.7% in the diagnosis of anterior cruciate ligament tear.

Conclusion: lelli’s test is easy to perform and superior to other manual tests for clinician in diagnosing ACL injury, even in acute injury as well as in post ACL reconstruction.

Keyword:Anterior cruciate ligament; Lelli’s test; Arthroscopy; Diagnostic accuracy