Topic
McMurray test
About: McMurray test is a research topic. Over the lifetime, 86 publications have been published within this topic receiving 2505 citations.
Papers published on a yearly basis
Papers
TL;DR: The composite examination for specific meniscal or ligamentous injuries of the knee performed much better than specific maneuvers, suggesting that synthesis of a group of examination maneuvers and historical items may be required for adequate diagnosis.
Abstract: ContextWhile most meniscal or ligamentous knee injuries heal with nonoperative
treatments, a subset should be treated with arthroscopic or open surgery.ObjectiveTo analyze the accuracy of the clinical examination for meniscal or
ligamentous knee injuries.Data SourcesMEDLINE (1966-December 31, 2000) and HealthSTAR (1975-December 31, 2000)
databases were searched for English-language articles describing the diagnostic
accuracy of individual examination items for the knee and a combination of
physical examination items (composite examination). Other data sources included
reference lists from relevant articles.Study SelectionStudies selected for data extraction were those that compared the performance
of the physical examination of the knee with a reference standard, such as
arthroscopy, arthrotomy, or magnetic resonance imaging. Eighty-eight articles
were identified, of which 23 (26%) met inclusion criteria.Data ExtractionA rheumatologist and an orthopedic surgeon independently reviewed each
article using a standardized rating scale that scored the assembly of the
study, the relevance of the patients enrolled, the appropriateness of the
reference standard, and the blinding of the examiner.Data SynthesisSummary likelihood ratios (LRs) were estimated from random effects models.
The summary LRs for physical examination for tears of the anterior cruciate
ligament, using the anterior drawer test, were 3.8 (95% confidence interval
[CI], 0.7-22.0) for a positive examination and 0.30 (95% CI, 0.05-1.50) for
a negative examination; the Lachman test, 25.0 (95% CI, 2.7-651.0) and 0.1
(95% CI, 0.0-0.4); and the composite assessment, 25.0 (95% CI, 2.1-306.0)
and 0.04 (95% CI, 0.01-0.48), respectively. The LRs could not be generated
for any specific examination maneuver for a posterior cruciate ligament tear,
but the composite assessment had an LR of 21.0 (95% CI, 2.1-205.0) for a positive
examination and 0.05 (95% CI, 0.01-0.50) for a negative examination. Determination
of meniscal lesions, using McMurray test, had an LR of 1.3 (95% CI, 0.9-1.7)
for a positive examination and 0.8 (95% CI, 0.6-1.1) for a negative examination;
joint line tenderness, 0.9 (95% CI, 0.8-1.0) and 1.1 (95% CI, 1.0-1.3); and
the composite assessment, 2.7 (95% CI, 1.4-5.1) and 0.4 (95% CI, 0.2-0.7),
respectively.ConclusionThe composite examination for specific meniscal or ligamentous injuries
of the knee performed much better than specific maneuvers, suggesting that
synthesis of a group of examination maneuvers and historical items may be
required for adequate diagnosis.
268 citations
TL;DR: It is felt that meniscus repair in patients 40 years and older is an effective treatment for peripherally located meniscal tears and repair of peripheral tears is indicated in this age group especially in conjunction with anterior cruciate ligament reconstruction.
Abstract: The critical role that the meniscus plays in the knee along with the advantages of preserving as much of the meniscus as possible have both been well documented. Whenever possible, meniscus repair has become the procedure of choice for treatment of meniscal tears. However, some researchers have reported less favorable results in older patients. To determine the results of meniscus repair in older patients, patients 40 years and older who underwent arthroscopically assisted meniscus repair were prospectively followed up. Thirty-seven patients were included in the study, all of which had a minimum 2-year follow-up (average, 26.5 months). The average age of the patients at the time of the repair was 44.2 years (range, 40 to 52 years); 26 were males and 11 were females. There were 19 left knees and 18 right knees included in the study. Twenty-two patients had associated anterior cruciate ligament reconstructions. Physical examination at follow-up included swelling, joint line tenderness, locking, and McMurray testing and radiographs. Five of 37 menisci repaired (13.5%) were symptomatic at latest follow-up. All of these patients had joint line tenderness and two had a positive McMurray test. Three of these patients had repeat arthroscopy confirming that the meniscus had not healed. Because of the small number of patients with symptoms at follow-up, the authors feel that meniscus repair in patients 40 years and older is an effective treatment for peripherally located meniscus tears. With 86.5% of the patients having good clinical results, these findings are comparable with other studies with a younger population and signify that repair of peripheral tears is indicated in this age group especially in conjunction with anterior cruciate ligament reconstruction. The findings suggest that the location and meniscal tear, rather than the age of the patient, determine the potential for successful repair. (Arthroscopy 1998 Nov-Dec;14(8):824-9.)
218 citations
TL;DR: The Thessaly test at 20 degrees of knee flexion can be used effectively as a first-line clinical screening test for meniscal tears, reducing the need for and the cost of modern magnetic resonance imaging methods.
Abstract: Background: Clinical tests used for the detection of meniscal tears in the knee do not present acceptable diagnostic sensitivity and specificity values. Diagnostic accuracy is improved by arthroscopic evaluation or magnetic resonance imaging studies. The objective of this study was to evaluate the diagnostic accuracy of a new dynamic clinical examination test for the detection of meniscal tears.
Methods: Two hundred and thirteen symptomatic patients with knee injuries who were examined clinically, had magnetic resonance imaging studies performed, and underwent arthroscopic surgery and 197 asymptomatic volunteers who were examined clinically and had magnetic resonance imaging studies done of their normal knees were included in this study. For clinical examination, the medial and lateral joint-line tenderness test, the McMurray test, the Apley compression and distraction test, the Thessaly test at 5° of knee flexion, and the Thessaly test at 20° of knee flexion were used. For all clinical tests, the sensitivity, specificity, false-positive, false-negative, and diagnostic accuracy rates were calculated and compared with the arthroscopic and magnetic resonance imaging data for the test subjects and the magnetic resonance imaging data for the control population.
Results: The Thessaly test at 20° of knee flexion had a high diagnostic accuracy rate of 94% in the detection of tears of the medial meniscus and 96% in the detection of tears of the lateral meniscus, and it had a low rate of false-positive and false-negative recordings. Other traditional clinical examination tests, with the exception of joint-line tenderness, which presented a diagnostic accuracy rate of 89% in the detection of lateral meniscal tears, showed inferior rates.
Conclusions: The Thessaly test at 20° of knee flexion can be used effectively as a first-line clinical screening test for meniscal tears, reducing the need for and the cost of modern magnetic resonance imaging methods.
Level of Evidence: Diagnostic Level I. See Instructions to Authors for a complete description of levels of evidence.
192 citations
1 Jan 2001
TL;DR: The composite examination for specific meniscal or ligamentous injuries of the knee performed much better than specific maneuvers, suggesting that synthesis of a group of examination maneuvers and historical items may be required for adequate diagnosis.
Abstract: ment, using the anterior drawer test, were 3.8 (95% confidence interval [CI], 0.7-22.0) for a positive examination and 0.30 (95% CI, 0.05-1.50) for a negative examination; the Lachman test, 25.0 (95% CI, 2.7-651.0) and 0.1 (95% CI, 0.0-0.4); and the composite assessment, 25.0 (95% CI, 2.1-306.0) and 0.04 (95% CI, 0.01-0.48), respectively. The LRs could not be generated for any specific examination maneuver for a posterior cruciate ligament tear, but the composite assessment had an LR of 21.0 (95% CI, 2.1-205.0) for a positive examination and 0.05 (95% CI, 0.01-0.50) for a negative examination. Determination of meniscal lesions, using McMurray test, had an LR of 1.3 (95% CI, 0.9-1.7) for a positive examination and 0.8 (95% CI, 0.6-1.1) for a negative examination; joint line tenderness, 0.9 (95% CI, 0.8-1.0) and 1.1 (95% CI, 1.0-1.3); and the composite assessment, 2.7 (95% CI, 1.4-5.1) and 0.4 (95% CI, 0.2-0.7), respectively. Conclusion The composite examination for specific meniscal or ligamentous injuries of the knee performed much better than specific maneuvers, suggesting that synthesis of a group of examination maneuvers and historical items may be required for adequate diagnosis.
190 citations
Atos1
TL;DR: The results show that arthroscopic meniscal repair with the FasT-Fix repair system provided a high rate of meniscus healing and appeared to be safe and effective in this group of patients.
Abstract: Purpose: The goal of this prospective study was to evaluate the results of arthroscopic meniscal repair using the FasT-Fix repair system. Type of Study: Prospective case series. Methods: Sixty-one meniscal repairs with the FasT-Fix meniscal repair system in 58 patients with a mean age of 32.6 years were performed between 2001 and 2002. Concurrent anterior cruciate ligament reconstruction was performed in 36 patients (62%). All tears were longitudinal and located in the red/red or red/white zone. Criteria for clinical success included absence of joint-line tenderness, locking, swelling, and a negative McMurray test. Clinical evaluation also included the Tegner and Lysholm knee scores, and KT-1000 arthrometry. In addition, all patients were evaluated preoperatively with magnetic resonance imaging. Results: The average follow-up was 18 months (range, 14 to 28 months). Six of 61 repaired menisci (9.8%) were considered failures according to our criteria. Therefore, the success rate was 90.2%. Time required for meniscal repair averaged 11 minutes. Postoperatively, the majority of the patients had no restrictions in sports activities. The mean Lysholm significantly improved from 43.6 preoperatively to 87.5 postoperatively ( P Conclusions: Our results show that arthroscopic meniscal repair with the FasT-Fix repair system provided a high rate of meniscus healing and appeared to be safe and effective in this group of patients. Level of Evidence: Level IV, therapeutic study, case series (no control group).
188 citations
Related Topics (5)
Performance Metrics
| Year | Papers |
|---|---|
| 2021 | 4 |
| 2020 | 7 |
| 2019 | 4 |
| 2018 | 1 |
| 2017 | 3 |
| 2016 | 3 |