Evidence Based Rehab

I have recently begun using a nice new clinical test for meniscus tears. It is called the Thessaly Test (I thought we were going to quit naming things like this after ourselves, lol). It is a weight bearing test, so it's fairly functional. The Abstract can be found on the Journal of Bone and Joint surgery. The test basically requires the practitioner to hold the hands of the patient who is standing on one leg. The patient then bends to 5° and twists medially then laterally. The test is repeated at 20°. Positive test equates to reproduction of pain, catching or popping.

Here is a summary from EBM Online:

Diagnosis Sensitivity (95% CI) Specificity (CI) Accuracy +LR –LR Medial meniscal tear 89% (83 to 94) 97% (94 to 98) 94% 26.9 0.11 Lateral meniscal tear 92% (78 to 98) 96% (93 to 98) 96% 22.9 0.08 *Diagnostic terms defined in glossary; CI and LRs calculated from data in article.

In my experience, the test is easy to administer and less physical work needed by the practitioner compared to McMurray's or Apley Grind. However, like McMurray's or Apley, in the clinic, they don't quit appear as strong individually as they do when grouped.

Labels: EBM, meniscus tear, special test, Thessaly