Abstract
Purpose
The purpose is to assess the diagnostic accuracy of a provocative test coined as the ‘posterior compression test’ (PCT) in those with the suspected posterior labral tear or lesion.
Methods
A total of 515 ‘arthroscopic labral repairs’ were identified between April 2013 and September 2020. Excluding those with concomitant shoulder pathologies, and only including those with pre-operative documentation of the PCT and/or the Jerk test, 191 patients were included. For the purposes of the analyses, the patients were divided into ‘non-posterior’ labral tear group which included the anterior labral tears and/or the superior labral anterior-to-posterior (SLAP) tears, versus ‘any posterior’ labral tear group which included the isolated posterior labral tears, the SLAP tears with posterior extension and the pan-labral tears.
Results
When the PCT was performed for the isolated posterior labral tears, the sensitivity was 92.6% with the specificity of 86.5%. The positive predictive value and negative predictive value were 71.4–97%, respectively. The Jerk test’s sensitivity was 77.8% but when the two tests were combined, the sensitivity increased up to 96.3%. The combined sensitivity with the Jerk test was still up to 94.6% with the AUC (area under curve) /ROC (receiver operator characteristic) at 0.855. Low ‘false-positive’ rate with the PCT was observed when the test was performed for the ‘non-posterior’ labral group, with the sensitivity of 13.5%.
Conclusions
The posterior compression test correlated well with the arthroscopic diagnoses in a subset of patients with suspected posterior labral pathology, possibly by means of direct stimulation.
Level of Evidence
III; Diagnostic Study.
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Data availability
The participants of this study did not give written consent for their data to be shared publicly, so due to the sensitive nature of the research supporting data is not available.
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Rhee, S., Youn, S., Lee, J. et al. Posterior Compression Test: a Provocative Test for Detecting Posterior Labral Tears. JOIO 58, 48–55 (2024). https://doi.org/10.1007/s43465-023-01028-9
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DOI: https://doi.org/10.1007/s43465-023-01028-9