Twenty-three diagnostic accuracy studies (n=1,959) were included.
Medial or lateral cruciate ligament examination. There were no studies that adequately examined the diagnostic accuracy of the physical examination for medial or lateral cruciate ligament lesions.
Anterior cruciate ligament examination. Using the anterior draw test (3 studies, n=138), the summary LRs were 3.8 (95% CI: 0.7, 22.0) for a positive examination and 0.30 (95% CI: 0.05, 1.50) for a negative examination. Using the Lachmann test (1 study, n=41), the summary LRs were 42.0 (95% CI: 2.7, 651.0) and 0.1 (95% CI: 0.0, 0.4) for a positive and negative examination, respectively.
Using the composite assessment (3 studies, n=428), the summary LRs were 25.0 (95% CI: 2.1, 306.0) and 0.04 (95% CI: 0.01, 0.48) for a positive and negative examination, respectively.
Posterior cruciate ligament examination.
The LRs could not be generated for any specific examination manoeuvre for a posterior ligament tear.
Using the composite assessment (2 studies, n=274), the summary LRs were 21.0 (95% CI: 2.1, 205.0) for a positive examination and 0.05 (95% CI: 0.01, 0.50) for a negative examination.
Meniscal examination.
Using the McMurray test (3 studies, n=344), the summary LRs were 1.3 (95% CI: 0.9, 1.7) for a positive examination and 0.8 (95% CI: 0.6, 1.1) for a negative examination.
For joint line tenderness (2 studies, n=244), the summary LRs were 0.9 (95% CI: 0.8, 1.0) and 1.1 (95% CI: 1.0, 1.3) for a positive and negative examination, respectively.
Using the composite assessment (5 studies, n=594), the summary LRs were 2.7 (95% CI: 1.4, 5.1) and 0.4 (95% CI: 0.2, 0.7) for a positive and negative examination, respectively.