Premium
Evaluation of the Drawer Test and the Tibial Compression Test for Differentiating Between Cranial and Caudal Stifle Subluxation Associated with Cruciate Ligament Instability
Author(s) -
Might Kelly R.,
Bachelez Andréas,
Martinez Steven A.,
Gay John M.
Publication year - 2013
Publication title -
veterinary surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.652
H-Index - 79
eISSN - 1532-950X
pISSN - 0161-3499
DOI - 10.1111/j.1532-950x.2012.01064.x
Subject(s) - medicine , cruciate ligament , cadaveric spasm , subluxation , stifle joint , anatomy , ligament , compression (physics) , nuclear medicine , anterior cruciate ligament , surgery , orthodontics , pathology , alternative medicine , materials science , composite material
Objective To determine the sensitivity and specificity of the drawer test ( DT ) alone and in combination with the tibial compression test ( TCT ) to detect stifle subluxation after transection of the cranial cruciate ( C r CL ), caudal cruciate ( C d CL ) or both cruciate ligaments (total cruciate ligament or TCL ). Study Design Experimental study. Sample Population Cadaveric, skeletally mature canine pelvic limb pairs (n = 8). Methods Pelvic limbs disarticulated at the coxofemoral joint were randomly assigned to the following 1 of 4 groups: (1) limbs had complete transection of the C r CL ; (2) limbs had complete transection of the C d CL ; (3) limbs had complete transection of both ligaments; and (4) both ligaments were left intact. Participants performed the DT and the TCT and a diagnosis was given based on the DT and on the combination of these tests. Results DT had a poor sensitivity for correctly identifying C r CL (69%), C d CL (45%), and TCL (26%) rupture, but had a high sensitivity when identifying intact limbs (97%). Specificity for DT was greatest when identifying limbs with C d CL (97%) and TCL (92%) rupture, and the lowest when palpating limbs with C r CL rupture (75%). Combining DT and TCT did not increase sensitivity or specificity values, nor did an increased level of evaluator training. Conclusions Independent of evaluator training, the DT alone or combined with the TCT poorly differentiates the cause of stifle instability associated with C r CL , C d CL , and TCL rupture.