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The Springing Block test compared to the conventional physical meniscus tests


Author: Ilona Laarman
Supervisor: Drs. Robbert Jan Noorda, MD. PhD

Background: Meniscal lesions are a common intra-articular knee injury. Physical examination tests used for assessing a tear of the meniscus are known to have a low sensitivity and specificity.

Purpose:  we investigated the diagnostic performance of the osteopathic Springing Block (SB) test to detect a tear of the meniscus compared to other meniscus tests.

Study design: Prospective blinded study

Methods: patients with indication for arthroscopy due to knee problems were studied using four different meniscus tests (SB t est, McMurray test, Joint Line Tenderness (JLT) test and Steinmann test). We analyzed sensitivity, specificity, positive and negative predictive value (PPV -NPV), and accuracy. To compare accuracy across the tests z -scores were used.

Results: Ninety-nine patients were collected (51 males, mean age 49.7) SB test for medial meniscus showed a PPV of 90%, specificity of 83,4% and sensitivity of 84,4% respect the other tests. The SB test showed higher accuracy respect the other tests in detecting both lesions (83 ,3% and 86.9% respectively), with a statistical significance especially for medial meniscus diagnosis (p<0,001 vs. MC Murray, p 0.019 vs. JLT, p 0.008 vs. Steinman).

Conclusion: the SB test showed higher test results especially for a meniscal tear compared to the conventional meniscus tests.

Keywords: Meniscus injury, meniscus test, Springy end feels, clinical examination, MRI, diagnostic valu