The significance of intracompartmental pressures in diagnosing chronic exertional compartment syndrome - A metaanalysis of studies monitoring dynamicanterior compartment pressures during exercise

Introduction: The chronic exertional compartment syndrome of the musculus t ibialis anterior is thought to be responsible for a major part of complaint s of the lower leg among active sportsmen. There is an important role of ti ssue pressure measurement in diagnosing chronic anterior compartment syndro me during muscular activity. However, there is a controversial debate about the relevant parameters. Methods: Metaanalysis of all the 21 studies (1979-1998) measuring intracomp artmental pressures during muscular activity. Parameters of analysis: type of exercise, catheter technique, recommendations of diagnostic criteria. Results: Analysis of literature shows that there has been no standardisatio n concerning the type of muscular exertion (isometrics for 5-10 min, exerci se on the treadmill between 3.2 and 12 km/h). In 8 of the 21 studies the re sults have been attained through the unsuitable Wick-catheter-technique. In the overall view none of the suggested criterions for diagnosis is taken u p by other teams. There are considerable variations up to 500% regarding th e recommended parameters. Conclusions: From all studies no uniform recommendation for parameters of d iagnostic relevance can be derived. On this background it should be demande d that future research is conducted by a uniform regimen for examination an d modern technique of measuring with a high temporal resolution. Under thes e standardised conditions the investigated parameters of the intracompartme ntal pressure curve should be reconsidered once more regarding diagnostic p redictability by calculations of specifity and sensitivity.