Feb 18

Validez de la prueba de Tesalia en la evaluación de las roturas de menisco en comparación con la artroscopia: un estudio de diagnóstico de la enfermedad / Validity of the thessaly test in evaluating meniscal tears compared with arthroscopy: a diagnostic accuracy study

Fuente
Este artículo es originalmente publicado en:
http://www.ncbi.nlm.nih.gov/pubmed/25420009
http://www.jospt.org/doi/abs/10.2519/jospt.2015.5215?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed#.VOTuJ_mG-nA
De:
Goossens P1, Keijsers E, van Geenen RJ, Zijta A, van den Broek M, Verhagen AP, Scholten-Peeters GG.

 J Orthop Sports Phys Ther. 2015 Jan;45(1):18-24. doi: 10.2519/jospt.2015.5215
Todos los derechos reservados para:
©2015 Journal of Orthopaedic & Sports Physical Therapy

Abstract

Study Design Diagnostic accuracy study. Objective To evaluate the diagnostic accuracy of the Thessaly test compared with an arthroscopic examination in patients with suspected meniscal tears. Background The Thessaly test was introduced to improve the diagnostic accuracy of the clinical examination in detecting meniscal tears. This test appears to be a valuable alternative to other meniscal clinical tests usually performed, but additional diagnostic accuracy data are required. Methods Patients with suspected meniscal tears, referred to a hospital for arthroscopic surgery, were eligible. The Thessaly test alone and the combination of the Thessaly and McMurray tests were considered as index tests, and arthroscopywas used as the reference test. Experienced physical therapists performed the Thessaly test at 20° of flexion and the McMurray test for both knees. The physical therapist was blinded to patient information, the affected knee, and the results from possible earlier diagnostic imaging. An orthopaedic surgeon blinded to the clinical test results from the physical therapist performed the arthroscopic examination. Results A total of 593 patients were included, of whom 493 (83%) had a meniscal tear, as determined by the arthroscopic examination. The Thessaly test had a sensitivity of 64% (95% confidence interval [CI]: 60%, 68%), specificity of 53% (95% CI: 43%, 63%), positive predictive value of 87% (95% CI: 83%, 90%), negative predictive value of 23% (95% CI: 18%, 29%), and positive and negative likelihood ratios of 1.37 (95% CI: 1.10, 1.70) and 0.68 (95% CI: 0.59, 0.78), respectively. The combination of positive Thessaly and McMurray tests showed a sensitivity of 53% and specificity of 62%. Conclusion The results of the Thessaly test alone or combined with the McMurray test do not seem useful to determine the presence or absence of meniscal tears. Level of Evidence Diagnosis, level 2b. J Orthop Sports Phys Ther 2015;45(1):18-24. Epub 24 Nov 2014. doi:10.2519/jospt.2015.5215.
Abstracto
Diseño del estudio estudio de exactitud diagnóstica. Objetivo: Evaluar la exactitud diagnóstica de la prueba de Tesalia en comparación con un examen artroscópico en pacientes con sospecha de roturas de menisco. Antecedentes La prueba de Tesalia se introdujo para mejorar la precisión diagnóstica de la exploración clínica en la detección de roturas de menisco. Esta prueba parece ser una alternativa valiosa para otras pruebas clínicas de menisco usualmente realizadas, pero se requieren datos de exactitud de diagnóstico adicionales. Los pacientes con sospecha de roturas de menisco, se refiere a un hospital para la cirugía artroscópica, fueron elegibles. La prueba Tesalia solo y la combinación de las pruebas de Tesalia y McMurray fueron considerados como pruebas de índice y arthroscopywas utilizados como prueba de referencia. Fisioterapeutas con experiencia realizaron la prueba de Tesalia a 20 ° de flexión y la prueba de McMurray para ambas rodillas. El fisioterapeuta fue cegado a la información del paciente, la rodilla afectada, y los resultados de posible diagnóstico por imagen anterior. Un cirujano ortopédico que desconocía los resultados de las pruebas clínicas de la fisioterapeuta realiza el examen artroscópico. Resultados Se incluyeron un total de 593 pacientes, de los cuales 493 (83%) tenían un desgarro de menisco, según lo determinado por el examen artroscópico. La prueba Tesalia tuvo una sensibilidad del 64% (95% intervalo de confianza [IC] del 60%, 68%), una especificidad del 53% (95% IC: 43%, 63%), el valor predictivo positivo del 87% (95% IC: 83%, 90%), el valor predictivo negativo del 23% (95% IC: 18%, 29%), y los cocientes de probabilidad positivos y negativos de CI 1,37 (95%: 1,10, 1,70) y 0,68 (IC del 95% : 0,59, 0,78), respectivamente. La combinación de las pruebas de Tesalia y McMurray positivos mostró una sensibilidad del 53% y una especificidad del 62%. Conclusión Los resultados de la prueba de Tesalia sola o combinada con la prueba de McMurray no parece útil para determinar la presencia o ausencia de roturas de menisco.

KEYWORDS:

McMurray; knee; meniscus; sensitivity; specificity
PMID:

 

25420009

 

[PubMed – in process]

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