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Arthrometric Evaluation of Posterior Cruciate Ligament Injuries

Sports Medicine Center, Department of Orthopaedic Surgery, University of California, San Francisco, California

* Address correspondence and reprint requests to Colin L. Eakin, MD, Palo Alto Medical Foundation, Division of Sports Medicine, 913 Emerson Street, Palo Alto, CA 94301

We reviewed the clinical examinations and knee arthrometry evaluations of 40 patients: 10 with posterior cruciate ligament injuries, 10 with combination anterior and posterior cruciate ligament injuries, 10 with anterior cruciate ligament injuries alone, and 10 with no history of knee injury. Using a 3-mm side-to-side difference as the minimal limit for detection of posterior cruciate ligament injury, the sensitivity of the arthrometer at 40 pounds of posterior force was 90%, the specificity was 100%, the predictive value of a positive test was 100%, and the predictive value of a negative test was 91%. When total anterior-posterior translation was assessed, the sensitivity was 100%, the specificity was 85%, the predictive value of a positive test was 87%, and the predictive value of a negative test was 100%. The overall accuracy of arthrometry for detection of posterior cruciate ligament injury was 96% for 40 pounds of posterior force and 94% for total anterior-posterior translation at 40 pounds. Grade 1 posterior cruciate ligament injuries had significantly greater arthrometric posterior translation compared with grade 0 (normal) knees. Regression analysis showed arthrometric laxity measurements correlated well with the clinical grade of the posterior drawer test. Finally, the accuracy of the arthrometer was not affected by concomitant anterior cruciate ligament injury.

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