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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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 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 ★★★★★☆☆


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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  • For correspondence: Dr L M Bachmann, Zurich University, Zurich, Switzerland.

  • Source of funding: no external funding