Lampart et al: Evaluation of the accuracy and intra‐ and interobserver reliability of three manual laxity tests for canine cranial cruciate ligament rupture—An ex vivo kinetic and kinematic study
Veterinary Surgery 5, 2023

🔍 Key Findings

• Cranial drawer (CD), tibial compression (TCT), and tibial pivot compression test (TPCT) showed 100% sensitivity and specificity in differentiating intact from CCL-deficient stifles in this ex vivo model.
• TPCT elicited the highest cranial tibial translation (CTT) and internal tibial rotation, though differences in rotation did not reach statistical significance.
• Inter- and intraobserver agreement for CTT was excellent across all tests (ICC >0.9).
• Rotation and force application had greater variability, particularly with less experienced observers and during CD.
• Forces applied during CD were significantly higher in intact limbs and correlated with observer experience.
• Subjective CTT estimates strongly correlated with objective kinematic measurements (r = 0.895), with a median absolute error of 1.31 mm.
• TPCT may be particularly useful for assessing rotational instability, mimicking the pivot-shift test used in human ACL exams.
• Study supports development of a grading system for manual laxity testing, especially in acute CCLR cases.