Common Physical Examination Tests for Patellofemoral Instability Demonstrate Weak Inter-Rater Reliability

Description

In this presentation, Sarah Kerslake discusses research focused on the reliability of common physical examination tests for evaluating patellofemoral instability. The research highlights challenges in diagnosing this condition, which relies on comprehensive history-taking, physical examinations, and imaging. Findings reveal that the inter-rater reliability of the Q-angle, J-sign, and apprehension test—key assessments for recurrent lateral patellofemoral instability—was weak. The study involved two orthopedic surgeons who assessed 38 subjects, revealing inconsistent results that may stem from the tests' inherent lack of validity rather than examiner skills. The analysis indicated that agreement on the dichotomous grading for J-sign and apprehension test varied between knees, thereby questioning the utility of these tests in clinical settings. Kerslake concludes by emphasizing the need for further research to enhance the reliability of evaluation methods in this field.

DOI: 10.1302/3114-220839

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