Ottawa Knee Rules

Purpose: The Ottawa Knee Rules were developed in order to determine the need for radiographs after acute knee injury secondary to the risk of fracture.

Stage of CPR Development: Validated.

Rule:

1. Age > 55
2. Tenderness at the head of the fibula
3. Isolated tenderness of the patella during palpation
4. Inability to flex the knee to 90 degrees
5. Inability to bear weight immediately and upon ER evaluation

Interpretation:

Study	Sensitivity	Specificity	-LR	NPV
Stiell et al., 1996	1.00	0.50	0.02	N/A
Diercks et al., 1997	1.00	0.38	0.19	N/A
Richman et al., 1997	0.85	0.45	0.34	N/A
Stiell et al., 1997	1.00	0.48	0.02	N/A
Seaberg et al., 1998	0.97	0.27	0.13	N/A
Tigges et al., 1999	0.98	0.19	0.12	N/A
Cook et al., 2001	1.00	0.42	0.24	N/A
Emparanza et al., 2001	1.00	0.52	0.01	N/A
Khine et al., 2001	0.92	0.49	0.16	N/A
Szucs et al., 2001	1.00	0.47	0.12	N/A
Ketelslegers et al., 2002	1.00	0.32	N/A	100%
Kec et al., 2003	0.70-1.00	0.25-0.33	N/A	91-100%
Bullock et al., 2003	1.00	0.43	N/A	100%
Jenny et al., 2005	1.00	0.35	N/A	N/A
Jalili et al., 2010	0.95	0.44	0.09	99.1%
Konan et al., 2013	1.00	0.23	N/A	100%
Cheung et al., 2013	0.86	0.23	N/A	95%