The “Lelli Test” a modern and new clinical test for the diagnosis of anterior cruciate ligament lesions

Objectives: Over the past decade, Dr. Alessandro Lelli’s new functional clinical test, the Lelli Test or the Lever Sign Test, has supplemented traditional clinical tests and magnetic resonance imaging (MRI) investigations to diagnose partial and complete anterior cruciate ligament (ACL) lesions. The present study describes the test’s sensitivity in 3000 patients with complete or partial ACL injuries, even with negative MRI reports. Materials and Methods: A prospective study with its analysis of various test sensitivity to diagnose an ACL lesion in comparison to Lelli’s Test was done in the authors’ institute. Results: All tests were nearly 100% sensitive for patients with chronic complete ACL tears. However, with acute or partial ACL lesions, even with a negative MRI report, the sensitivity was much lower for the Lachman, Anterior Drawer, and Pivot Shift tests, but not the Lelli test. This level III evidence prospective clinical study of 3000 patients showed the mean sensitivity as 0.61 for the Lachman test, 0.67 for the Anterior Drawer test, 0.47 for the Pivot Shift test, and 0.97 for the Lelli test. Conclusion: The Lelli or Lever sign test is more sensitive to diagnosing acute and partial ACL tears correctly than standard manual tests, even in patients with negative MRI reports. This test’s key feature is distinguishing a healthy, intact, functionally valid ACL from a healthy, intact, but functionally invalid ACL.