Knee Injury Essay

1855 Words 8 Pages
Introduction

Knee injuries are common in individuals that perform in the sports that require quick movements. These quick movements put the person at a high risk of suffering an injury to the knee. Of these injuries, the most common are meniscal and anterior cruciate ligament (ACL) tears. When a person suffers a potential injury they must be diagnosed by a qualified healthcare professional prior to deciding on an intervention to correct the tear. There are many different methods of diagnosis: magnetic resonance imaging (MRI), arthroscopy and clinical tests. There are three clinical tests that are commonly used which are the pivot-shift test, drawer, and Lachman’s test. The patient’s socioeconomic status, prior level of function, and desired
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Did the investigators limit the review to high-quality studies? The methods through which the articles were chosen was rigorous, but there was no mention of the level of evidence of the studies.
2. Did the investigators implement a comprehensive search and study selection process? Yes. The researchers performed a rigorous search from several databases: MEDLINE, EMBASE, and AMED. The inclusion criteria consisted of articles that are written in English or German, included all subjects of all ages, and who exhibited acute or chronic symptomatology. Exclusion criteria were: animal or cadaver studies, studies that utilized device supported exams, studies that lacked description of the test performed.
3. Did the investigators assess the quality of individual studies with standardized processes and/or tools? Yes. Two independent investigators used the QAREL tool to assess methodological quality.
4. Did the investigators provide details about the research validity (or quality) of studies included in the review? Yes. The investigators used the QAREL tool to assess validity and determine the quality of the study. A table which indicated level of bias in each study was included in the methodological explanation of the
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Did the investigators evaluate (or provide a citation for) the reliability of the index diagnostic test? The investigators did account for the reliability of the diagnostic tests using five parameters that consisted of: sensitivity, specificity, accuracy and positive and negative predictive value.
3. Did the investigators compare results from the index test to results from a “gold standard” diagnostic test? Yes. Results from MRI and physical examination were compared with the “gold standard” of arthroscopy.
4. Were all subjects evaluated with the comparison diagnostic test? Yes. All subjects were evaluated with both the MRI and physical examination diagnostic tests.
5. Were the individuals performing and interpreting each test’s results unaware of the other test’s results (i.e. were they masked or blinded?) No. The orthopaedic surgeon (senior author) was blinded, but the radiologist was aware of the clinical diagnosis.
6. Was the time between application of the index test and the “gold standard” comparison diagnostic test short enough to minimize the opportunity for change in the subjects condition? Yes. The study was done over a five week period and confirmed by arthroscopy following the diagnostic interventions. This time period was brief enough to minimize opportunity for the subjects’ conditions to

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