Knee Flashcards
Patella Apprehension
Position: supine with knee flexed at 30 degrees and quads relaxed
Force: one hand stabilizes the leg while the other applies a lateral translation force on the patella with examiners thumbs
Positive Findings: a positive test consists of orally expressed apprehension or apprehensive quadriceps recruitment on the provocation test
*sublux or dislocation
Q-angle test
positon: supine with knee extended
Force: goni measurement line reps the line of force of the quadriceps is made by connecting a point near the ASIS to the midpoint of the patella. Stable arm is the line of the patella to the tibial tuberosity
Findings: males = 13 degrees and females = 18 degrees
abnormal is less than 13/greater than 18. Q-angle of less than 13 is associated with CMP. Q-angle greater than 18 indicates CMP or sublimated patella
Lachman Test
Position: supine. knee flexed to 20-30 degrees. examiner stands with proximal hand onto subjects distal thigh (laterally) immediately proximal to the patella, and the distal hand on the subjects proximal tibia (medially) immediately distal to the tibial tubercle
Action: from a neutral (AP) position, apply an anterior force to the tibia with the distal hand while stabilizing the femur with the proximal hand
Finding: excessive anterior translation of the tibia as compared to the uninvolved knee with a diminished or absent endpoint is indicative of a partial or complete tear of the ACL
Anterior Drawer Test
Position: supine with test hip flexed to 45 degrees, knee flexed to 90 and foot in neutral. examiner sits on subjects foot with both hands behind the subjects proximal tibia and thumbs on the tibial plateau
Action: apply a anterior force to the proximal tibia. the hamstring tendons should be palpated frequently with the index fingers to ensure relaxation
Positive Finding: increased anterior tibial displacement as compared to the uninvolved side
Slocum Drawer Test (Internal Rotation)
Position: supine with hip flexed 45 and knee at 90, examiner internally rotates tibia (15-20) 30 degrees
Action: apply an anterior force to the proximal tibia. the hamstrings should be relaxed
Findings: increased anterior tibial displacement, particularly of the lateral tibial condyle, as compared to the uninvolved side is indicative of anterolateral rotary instability (secondary to a partial or complete tear of the ACL and posterolateral capsule)
**Mainly ACL but could also be LCL, PCL, IT band
Slocum Drawer Test (external rotation)
Position: supine with hip flexed 45, knee 90 and tibia in external rotation
Action: apply an anterior force to the proximal tibia. the hamstrings should be relaxed
Findings: increased anterior tibial displacement, particularly of the medial tibial condyle, as compared to the uninvolved side is indicative of anteromedial rotary instability secondary to damage to primarily the medial collateral ligament, ACL, and posteromedial capsule.
