Knee Ortho Tests Flashcards
Lachmann’s Drawer Test Technique
Aim: One-plane anterior instability/acl
Action: Supine, knee flexed to 30, foot on table. Hold lateral thigh, support post. femur. Holding proximal aspect of tibia, thumb on tibial tuberosity, drawer tibia anteriorly, whilst stabilising the femur
+ve: Increased anterior excursion of tibia on femur. Change in end feel. Diminished slope of infrapatellar tend.
Pivot Shift Test Technique
Aim: To assess ALRI and ACL laxity
Action: Supine, hip at 45 flexion and 30 abduction. Knee at 50 flexion with valgus strain and internal tibial rotation. Flexes and extends knee, palpating for movement/translation of lateral tibial condyle
+ve: -Upon extension of knee, lateral tibial condyle SHIFTS/‘CLUNKS’ anteriorly - (clunk not always present)
-Lateral tibial condyle can be reduced posteriorly by reversing the test, due to 30 knee flexion changing position of ITB from extensor to flexor
McMurray’s test TECHNIQUE
Aim: Assessment of pain/apprehension due to meniscal injury or pathology
Action: -Same setup as knee exam, with knee optional on table to prevent hyperextension. -Knee fully flexed, with full tibial external rotation applied. -Knee slowly extended, palpating meniscal areas for click, or observing pain/apprehension. -Knee returned to full flexion, and repeated with tibial internal rotation.
+ve: -Reproduction of patient symptoms, pain, apprehension, or ‘click’. - Usually reproducible through some range of motion if true meniscal lesion
McConnell test TECHNIQUE
Aim: to assess for pain coming from patellofemoral articulation
Action: -Pt sat on edge of raised couch, with knees flexed over side. -Practitioner creates isometric knee extension by resisting pt extension
-Done in positions of 120, 90, 60, 30, and 0 of knee flexion. -If pain produced in any position, practitioner applies medial glide to patella and repeats to see if pain reduces.
+Ve: Pain on sustained isometric contraction of quads, that is relieved by medial gliding of patella
