Orthopedic Tip of
the Month
BRAND NEW TEST
"The Thessaly Test" for early detection of meniscal
tears.
The Thessaly test is a dynamic reproduction
of load transmission in the knee joint and is
performed at 5 and 20 degrees of flexion.
It was named in the honor of the county, where
the hospital serves as an academic medical referral
center.
It is performed by the examiner supporting the patient by holding his/her outstretched hands while the patient stands flatfooted on the floor. The patient then rotates his or her knee and body, internally and externally, 3 times, keeping the knee in slight flexion (5 degrees). Then the same procedure is carried out with the knee flexed at 20 degrees. Patients with suspected meniscal tears experience medial or lateral joint-line discomfort and may have a sense of locking or catching. The theory is that the meniscal tear is subjected to excessive loading conditions with this test and almost certainly will have the same symptomss that the patient reported. The test is ALWAYS performed on the normal knee first.
Results: The Thessaly test at 20 degrees of knee flexion has a high diagnostic accuracy rate of 94% in the detection of tears of the medial meniscus and 96% in the detection of tears of the lateral meniscus, and had a low rate of false-positive and false-negative readings. Other traditional clinical exam tests, with the exception of joint tenderess, presented a diagnostic accuracy of 89% in detection of lateral meniscus tears, showed inferior rates.
Journal of Bone & Joint Surgery 2005. pgs. 955 - 962
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