Lelli's Test in ACL Injuries

Abstract

Introduction: Anterior cruciate ligament (ACL) injuries are common and impact knee function. Accurate diagnosis is essential, with MRI as a reliable non-invasive method and arthroscopy as the gold standard. Clinical tests like Lachman, anterior drawer, pivot shift, and commonly used for ACL evaluation. Lelli's test is a simple, non-invasive tool, and this study evaluates its sensitivity, specificity, and diagnostic accuracy compared to arthroscopy.

Objective: This study aims to assess the sensitivity and specificity of Lelli's test in diagnosing anterior cruciate ligament (ACL) injuries and compares its diagnostic accuracy with that of arthroscopy.

Methods: This study included 188 patients with suspected ACL injuries presenting at the Department of Orthopaedics, Government Medical College, Kottayam. Each patient underwent standard tests, including the Lachman, anterior drawer, pivot shift. Lelli's test involved applying a posterior force to the quadriceps tendon, with heel liftoff indicating a negative result. Test results were recorded and compared to arthroscopy findings. Sensitivity, specificity, and diagnostic accuracy of each test were calculated.

Results: The Lachman test had the highest sensitivity (95.09%) and specificity (88%). Lelli's test showed a sensitivity of 91.41% and specificity of 88%, demonstrating good accuracy for diagnosing ACL injuries. The anterior drawer test had a sensitivity of 85.54% and specificity of 88.85%. The pivot shift test showed the lowest sensitivity (65.64%) and specificity (60%).

Conclusion: Lelli's test is a simple and reliable method for diagnosing ACL injuries, with diagnostic accuracy comparable to other clinical tests. It can be effectively used in both acute and chronic knee injuries but should be combined with other diagnostic tools for comprehensive evaluation.