Posterior Compression Test: a Provocative Test for Detecting Posterior Labral Tears

Sung Min Rhee; Seung Min Youn; Jong Ung Lee; Cheol Hwan Kim; Se Yeon Kim; Hyun Joo Ham; Yong Girl Rhee

doi:10.1007/s43465-023-01028-9

Posterior Compression Test: a Provocative Test for Detecting Posterior Labral Tears

Indian J Orthop. 2023 Nov 26;58(1):48-55. doi: 10.1007/s43465-023-01028-9. eCollection 2024 Jan.

Authors

Sung Min Rhee¹, Seung Min Youn², Jong Ung Lee³, Cheol Hwan Kim³, Se Yeon Kim³, Hyun Joo Ham³, Yong Girl Rhee³

Affiliations

¹ Shoulder and Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University Hospital, Seoul, Korea.
² The Department of Orthopaedic Surgery, Royal Brisbane and Women's Hospital, Butterfield St, Herston, QLD Australia.
³ Department of Orthopaedic Surgery, Myongji Hospital, 697-24 Hwajung-Dong, Deokyang-Gu, Goyang-Si, Gyeonggi-Do, 10475 Korea.

PMID: 38161393
PMCID: PMC10754776 (available on 2024-11-26)
DOI: 10.1007/s43465-023-01028-9

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.

Keywords: Diagnostic test; Posterior compression test; Posterior labral tear.

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