Execution:
- Patient is in prone position to eliminate posterior sag of the tibia
- The examiner brings the patient’s knees into 30° of flexion, brings both feet into maximal dorsiflexion and externally rotates the patients tibia maximally
- The examiner now measures the foot-thigh angle and compares both sides
- The steps 2+3 are repeated with the knee in 90° of flexion
Positive Outcome: Isolated PCL injury if a side-difference of more than 10° of external rotation is found in 30° of flexion, but <10° of external rotation difference at 90° of knee flexion.
If external rotation differences of more than 10° are found at 30° and 90° of knee flexion, both – a PCL and PLC injury – are suspected.
|
Study |
Reliability | Sn | Sp | LR+ |
LR- |
| Krause et al. (2013):Evaluated with inclinometer |
Intra-rater к = 0.83-0.89 |
NA | NA | NA |
NA |
| Krause et al. (2013):Evaluated with inclinometer |
Intra-rater к = 0.74-0.83 |
NA | NA | NA |
NA |
| Norris et al. (2018): Intact PLC |
NA |
83 | 95 | 16.25 |
0.18 |
| Norris et al. (2018): Isolated PLC injury |
NA |
20 | 100 | ∞ |
0.8 |
| Norris et al. (2018): Combined (PLC+PCL) |
NA |
75 | 58 | 1.80 |
0.43 |
| Norris et al. (2018): Medial knee |
NA |
50 | 56 | 1.14 |
0.89 |
| Norris et al. (2018): Combined |
NA |
70 | 57 | 1.62 |
0.52 |
| Slichter et al. (2018): 30° flexion |
Inter-rater ĸ=0.29 | NA | NA | NA |
NA |
| Slichter et al. (2018): 90° flexion |
Inter-rater ĸ=0.38 | NA | NA | NA |
NA |
| Comment: The results from Norris et al. (2018) suggest a negative dial test at 30° of knee flexion can rule out a PLC injury, while a test that is positive at 30° and negative at 90° indicates a PLC injury, without concomitant injury to the PCL or medial knee ligaments. A positive test at both 30° and 90° can indicate isolated PLC, combined PLC-PCL or medial ligament injuries, and other knee examination findings are required to differentially diagnose these injury patterns | |||||
