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  • Review: the Ottawa knee rule accurately rules out knee fractures and can substantially reduce the need for x rays in patients with acute knee injuries

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Review: the Ottawa knee rule accurately rules out knee fractures and can substantially reduce the need for x rays in patients with acute knee injuries

https://doi.org/10.1136/ebm.9.5.151

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    Bachmann LM, Haberzeth S, Steurer J, et al. The accuracy of the Ottawa knee rule to rule out knee fractures: a systematic review. Ann Intern Med 2004;140:121–4.
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 Q In patients with acute knee injuries, is the Ottawa knee rule (OKR) accurate for ruling out knee fractures?

    Clinical impact ratings GP/FP/Primary care ★★★★★☆☆ Emergency medicine ★★★★★☆☆ IM/Ambulatory care ★★★★★☆☆

    METHODS

    Embedded ImageData sources:

    Medline and PreMedline (1966 to January 2003), CINAHL (1982–2003), EMBASE/Excerpta Medica (1980–2003), Biosis (1990–2003), the Cochrane Library (2002), and the Science Citation Index database; reference lists; and experts.

    Embedded ImageStudy selection and assessment:

    studies in any language that assessed the OKR, investigated fractures confirmed radiographically or in combination with follow up; and reported enough information to calculate sensitivity, specificity, and likelihood ratios. Study quality was ranked as high quality (level 1  =  consecutive patient enrolment, reference standard test done on all patients, radiographic assessment of fracture done blinded to …

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