Lever Sign Test: Is it Sensitive for the Diagnosis of Anterior Cruciate Ligament Disruption?

Fahmy Samir Fahmy, MD; Hossam Fathi, MD


Curr Orthop Pract. 2019;30(4):343-346. 

In This Article


The sensitivities of the Lachman, anterior drawer, and pivot-shift test were 91%, 82%, and 88%, respectively, for each without interobserver variability between the examiners. The lever sign test had 66 false negative results and the recorded sensitivity was 34% (Table 2). Both examiners had the same results with 100% interobserver reliability. The test was negative in the normal contralateral knee of all patients.

Sensitivity of the the lever sign test was inferior to the other three tests (Video 1, Supplemental Digital Content 1, http://links.lww.com/COP/A28 shows a negative lever sign test but positive Lachman, anterior drawer, and pivot-shift tests in a patient with rerupture of previously reconstructed left ACL). There was a statistically significant difference between the results of this test and the other diagnostic tests with a P-value<0.05.