Interobserver concordance of St. Joseph Hospital sign in physical examination of the anterolateral knee instability
DOI:
https://doi.org/10.1016/j.rccot.2016.10.006Keywords:
knee instability anterolateral, clinical evaluation, anterior cruciate ligamentAbstract
Background: The Hospital of San José sign is a variant of pivot shift for the diagnosis of anterolateral instability of the knee. It is currently known that has a high sensitivity and specificity but do not have data to support clinical reproducibility, so the aim of this study was to determine the interobserver concordance of this sign on physical examination of patients with injury of the anterior cruciate ligament.
Materials and methods: Interobserver concordance among experienced knee surgeons and subspecialty residents was evaluated. 100 patients were evaluated in the knee and sports consultation. Patients were examined blindly and independently by one evaluator of each group, all evaluators were properly instructed in performing the maneuver.
Results: Only 41 patients had ACL injury confirmed by MRI. Group 1 performed a diagnosis of 61 healthy patients (without injury) and 39 patients with ACL injury, presenting 2 false negative; Group 2 made a diagnosis of 62 healthy patients 38 injured ACLs. Concordance among groups was 59 in healthy subjects and 37 in injured patients, resulting in an agreement of 97% with a index 0.937.
Discussion: It can be concluded that the Hospital San José sign is consistent and highly reproducible.
Evidence level: IV.
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