Knee Flashcards
Supine
Apply a valgus stress at the knee while the ankle is stabilized. Test is first done with knee in full extension and then with knee in 20° - 30° of flexion
Abduction Test
Medial instability
Tibia moves away from the femur excessively when a valgus stress is applied
Supine
Apply a varus stress at the knee while the ankle is stabilized. Test is first done with knee in full extension and then with knee in 20° - 30° of flexion
Adduction Test
Lateral instability
Tibia moves away from the femur an excessive amount when a varus stress is applied
Supine
Hold knee between full extension to 30° of flexion. Stabilize femur while proximal aspect of the tibia is moved forward with the other hand.
Lachman Test
Injury to ACL, posterior oblique ligament and arcuate-popliteus complex
“Mushy” feel when the tibia is moved forward disappearance of the infrapatellar tendon slope
Supine
Knee flexed to 90° and hip flexed to 45°. PT sits on the forefoot and the foot in neutral rotation. Ensure the hamstring muscles are relaxed. The tibia is drawn forward on the femur
Anterior Drawer Test
Injury to the ACL, posterolateral capsule, posteromedial capsule, MCL, IT band, etc.
Tibia moves forward more than 6mm on the femur
Supine
Flex hip, abduct 30° and relax at about 20°. Put leg in slight internal rotation. Apply a valgus stress to knee while maintaining a medial rotation torque on tibia at ankle.
Flex leg at approximately 30° - 40°. Tibia is drawn forward on the femur
When knee flexes tibia clunks backward at approximately 30° - 40°.
Lateral Pivot Shift Maneuver
Anterolateral rotatory instability Rupture of the ACL
At beginning of test, tibia was sublaxed, and then was reduced by pull of IT band as knee was flexed.
Supine
Flex hips to 45° and the knee flexed to 90°.
Posterior Sag Sign
Torn PCL
Tibia “drops back” on the femur
Prone
Flex knee to 30° and grasp tibia with while fixing the femur with the other hand. Pull tibia up
Reverse Lachman Test
Integrity of the PCL
Ligament laxity
Supine
Flex hip to 45° and flex knee to 90°. Passively glide tibia posteriorly
Posterior Drawer Test
Integrity of the PCL
Excessive posterior glide
Supine
Completely flex the knee. Internally rotate tibia and extend knee for the lateral meniscus.
For the medial meniscus, externally rotate the tibia and extends the knee.
McMurray Test
Meniscal tears
Reproduction of click and/or pain in the knee joint
Prone
Flex knee to 90°. Anchor thigh to table. Internally and externally rotate tibia along with distraction and note any restriction, excessive movement or discomfort.
Repeat process using compression instead of distraction
Apley’s Test
Differentiates between meniscal tears and ligamentous lesions.
Rotation with distraction is more painful/has increased rotation, then ligamentous lesion
Rotation plus compression is more painful/has decreased rotation, then meniscus injury
Supine
Extend knee and apply a straight tap or pressure over the patella.
Patellar Tap Test
Infrapatellar effusion
Feel a floating patella
Supine
Flex knee and internally rotate tibia while pressing patella medially and palpating the medial femoral condyle. Passively flex the knee and extend while feeling the plica band
Hughston’s Plica Test
Dysfunction of the plica
“Popping” of the plica
Supine
Press down slightly proximal to upper pole or base of the patella with knee extended. Patient contracts the quadriceps muscles and PT pushes down
Clarke’s Sign (Patellar Grind) Test
Patellofemoral dysfunction
Retropatellar pain and patient can’t hold a contraction
Supine
Passively glide patella laterally
Patellar Apprehension Test
Past history of patella dislocation
Patient resists moving patella in lateral direction for subluxation/dislocation
Supine
Flex knees. Tap area where common fibular nerve passes through posterior to fibula head
Tinel’s Sign
Dysfunction of the common fibular nerve
Repeat of tingling/ paresthesia in leg
