Knee Joint Flashcards
what is the collateral ligament stability test?
- Patient lying supine – support the lower leg or ankle and apply a valgus
stress (lateral to medial) to the knee = test MCL - Switch hands and apply a varus stress (medial to lateral) to the knee = test
LCL - Do tests first in full extension then in 20-30 degrees of flexion
Positive => excess movement or pain to the medial or lateral knee
what is the findings of collateral ligament stability
Damage to the MCL (upon valgus
stress) or LCL (upon varus stress)
what is the anterior and posterior drawer test?
- Patient lying supine with flexed knee and hip
- Sit on patients’ foot and place hands around knee with thumbs in the eyes
of the knee (medial and lateral to the patellar tendon) - Apply anterior force to test for ACL – repeat 2-3 times
- Apply posterior force to the tibia on the femur to test for PCL – repeat 2-3
times
Positive => excessive movement of the tibia on the femur
what are the findings for anterior and posterior drawer test
Anterior drawer
+ pain – ACL strain
+ excessive motion – ACL rupture
Posterior drawer
+ pain – PCL strain
+ excessive motion – PCL rupture
what is the Lachman test
- Patient lying supine with involved leg beside examiner
- Examiner holds patient’s knee between full extension and 30 flexion and
femur are stabilized with one of examiner’s hand - Move proximal aspect of the tibia forward using the other hand
Positive => mushy or soft end feel when tibia is moved forward on the femur and
the infrapatellar tendon slope disappears
what are the findings of the lachman test
Anterior
+ pain – ACL sprain
+ excessive motion – ACL rupture
Posterior
+ pain – PCL sprain
+ excessive motion – PCL rupture
what is the McMurray’s test
- Patient lying supine
- With one hand supporting the knee, other hand externally rotates the tibia
while taking patient out of knee flexion (into knee extension) - Repeat but with internal rotation of the knee
Positive => snap, click or pain to the lateral or medial kne
what are the findings of the McMurray’s test?
Medial (external rotation) or lateral
(internal rotation) meniscus
damage/tear
what is the Apley’s distraction test
- Patient lying prone and one leg flexed 90 degree
- Stabilize patient’s thigh by placing your knee on it
- Pull upwards on tibia while stabilizing thigh
- Rotate tibia internally then externally
Positive => pain in collateral ligaments or excessive motion or decreased
pain/crepitus with knee distraction
what are the findings of Apley’s Distraction test
Collateral ligament sprain
Meniscus tear (with decreased
pain)
what is the Apley’s Compression Test
- Patient lying prone and knee is flexed 90 degree
- Laterally rotate tibia and push down
- Then medially rotate tibia and push down
Positive => pain on medial side with lateral rotation or pain on lateral side with
medial rotation
what are the findings of Apley’s compression test
Medial or lateral meniscus
pathology (lesion)
what is the Ober’s Test (modified)
- Patient lying on their side with involved leg up
- Abduct and extend thigh while keeping the hip joint in neutral
- Slowly lower leg towards the table
- If IT band is normal, thigh should drop to the adducted position
Positive => thigh remains abducted when the leg is released
what is the finding of the Ober’s Test (modified)
Contracture of the IT band (more
than gluteus medius)
what is the Ober’s test (original)
- Patient lying on their side with involved leg up
- Abduct the leg and flex the knee to 90 while keeping hip joint in neutral
to relax IT band - If IT band is normal, the thigh should drop to the adducted position
Positive => thigh remains abducted when the leg is released
what is the findings of Ober’s Test (original)
Contracture of gluteus medius
(more than IT band)
what is the apprehension test
- Patient stands on affected knee
- Examiner pushes anteriorly and medially on the anterolateral part of the
lateral femoral condyle crossing the knee joint - Patient asked to slightly flex knee while examiner pushes with thumb
Positive => condylar movement and a “giving way” sensation
what is the finding of Apprehension test?
Posterolateral instability
what is the bounce home test?
- Patient lying supine
- Cup the heel of the patient’s foot
- Patient’s knee is completely flexed, and the knee is passively allowed to
extend
Positive => if extension is not complete or has a rubbery end feel (springy block)
what is the findings for bounce home test
torn meniscus
what is the Clarks patellar grind test
- Patient lying supine
- Examiner presses down slightly proximal to the base of the patella with
the web of the hand - Patient asked to contract quad muscles while examiner pushes down
Positive => pain or grinding sensation
what is the findings for the Clarks patellar grind test
Patellofemoral dysfunction
what is the thessaly test
- Patient stands flat footed on the affected leg – examiner provides hand for
balance - Patient flexes the knee to 20
- While maintaining flexion, patient rotates medially and laterally 3 times
Positive => pain or grinding sensation
what is the findings for the thessaly test
patellofemoral dysfunction
what are the special test for ACL sprain or tear
- Anterior drawer
+ pain – ACL strain
+ excessive motion –
ACL rupture - Lachman’s test
(anterior)
+ pain w/anterior
translation – ACL
sprain
+ excessive motion –
ACL rupture
what are the special test for PCL sprain or tear
- Posterior drawer test
+ pain – PCL strain
+ excessive motion –
PCL rupture - Lachman’s test
(posterior)
+ pain w/posterior
translation – PCL
sprain
+ excessive motion –
PCL rupture
what are the special test for MCL sprain or tear
Valgus stress test
(lateral to medial)
+ pain – MCL sprain
+ excessive motion or
gapping – MCL
rupture
what are the special test for LCL sprain or tear
Varus stress test
(medial to lateral)
+ pain – LCL strain
+ increased motion or
gapping – LCL rupture
what are the special test for meniscus tear
Apley’s compression
+ pain or crepitus with
compression/rotation –
meniscal lesion
Apley’s distraction
+ decreased pain or
crepitus with knee
distraction
McMurray’s test
+ pain or crepitus –
meniscal lesion
Valgus with external
rotation – lateral men.
Varus with internal
rotation – medial men.
what are the special test for Iliotibial band syndrome
OBERS (modified)
+ hip pain – hip joint
pathology
+ trochanteric pain –
trochanteric bursitis
+ decreased ROM –
ITB contracture
what are the special test for patellar dislocation
Patellar apprehension
test
what are the special test for Chondromalacia patella
Clark’s Patellar Grind
test
+ grinding sensation or
pain
what is the terrible or unhappy triad?
medial meniscus, ACL, and MCL and they are commonly affected together
