Knee Special Tests Flashcards
List the special tests that test for one-plane anterior instability?
- Lachman
- Anterior draw
- Active draw
List the special tests for one-plane posterior instability tests.
- Posterior Draw
2. Posterior Sag sign
List the special tests for Anterolateral instability.
- Slocum’s
2. Lateral Pivot Shift Maneuver (Test Of MacIntosh)
What position should the foot be placed in when testing for anterolateral and anteromedial instability during the Slocum’s test?
30 degrees IR and 15 degrees ER
Which special test tests for one-plane medial instability?
Valgus Stress Test
Which special test test for one-plane lateral instability at the knee?
Varus Stress test
List the special tests for Meniscal pathology.
- McMurray
- Apley’s
- Thessaly’s (gold standard)
- Bounce Home
The Tibial torsion special test is assessing?
Assess the amount of internal/external tibial rotation
The varus/valgus angle assesses?
Assess the angle between the femur and the tibia.
Clinician measures the varus/valgus angle of a patient and the results are 15 degrees on RLE and 12 degrees on LLE. Interpret the results.
> 10 degrees = Valgus; thus patient has bilateral valgus
A value of <5 degrees for the varus/valgus angle would indicate what?
Varus
Normal values for the varus/valgus angle is what?
5-10 degrees
During the valgus and varus stress test a positive test while the knee is extended would be mean?
More severe injury with several structures being injured
During the lateral pivot shift maneuver, during 30-40 degrees what should occur if the test is positive?
The Tibia will “jog” backwards and the patient will indicate that this is what if feels like when their knee “gives away”
Prior to performing lachman’s, what structure should be cleared to avoid a false positive?
The therapist should clear the PCL prior to performing any one-plane anterior instability tests
List the structures that may be involved with a positive varus test while the knee is flexed.
- LCL
- Bicep Femoris
- ITB
- Capsule
- Accurate-popliteus complex
List the structures that may be involved with a positive valgus test with knee flexed.
- MCL
- Post oblique ligament
- PCL
- Capsule
List the structures that may be involved with a positive Valgus Stress test when the knee is extended.
- MCL, PCL, ACL
- Capsule
- Medial quadriceps
- Semimembranosis
List the structures that maybe involved with a positive Varus Stress test while the knee is extended.
- LCL, capsule, ITB
- Bicep femoris
- Arcuate-popliteal complex
- PCL/ACL
- Lateral gastrocnemius
Positive test during the Lachman special test is indicated by?
- Mushy/soft end feel
2. Excessive tibial translations (>4mm)
If a therapist determines a positive lachman’s test (>4mm anterior tibial translation), what structures may be involved?
- ACL/PCL
2. Arcuate-popliteus complex
What is the position of the patient during lachman special test?
Supine with knee flexed between 0-30 degrees
A positive active drawer test is indicated by what?
> 6mm anterior tibial translation
If, <6mm anterior tibial translation indicates only ACL is torn
What structures may be involved with a positive anterior drawer test.
- ACL
- PL +PM capsule
- MCL (Deep fibers)
- ITB
- POL
- Arcuate-popliteus complex
List what structures are involved during a positive solcum’s test which indicates lateral instability of the knee.
- ACL/LCL/ PCL
- PL capsule
- Arcuate-popliteus complete
- ITB
List what structures are involved during a positive solcum’s test which indicates anteromedial instability of the knee.
- ACL/MCL
- POL
- PM capsule
What is the starting position of the patient during MacIntosh Test?
Patient is supine while test leg is flexed and abducted 30 degrees and relaxed in slight IR (20 degrees).
What is the starting testing position of the patient for Posterior Sag sign (gravity draw test)?
Patient lies supine with the hip flexed to 45 degrees and the knee flexed to 90 degrees
If a Posterior sag sign is positive, what structures may be involved?
- PCL/ACL
- POL
- Arcuate-popliteal complex
A therapist is performing a valgus stress test on a patient; in which direction should the therapist be applying for to stress MCL and medial structures?
Therapist should apply a MEDIALLY directed force at the Knee with ankle in slight ER.
In what positions should the valgus/varus stress test be performed in.
- Supine with knee flexed 20-30 degrees
2. Supine with knee fully extended (positive in this position is more severe)
A therapist is performing McMurray’s test on a patient. The therapist passively internally rotates the tibia while extending the knee with a varus force. The therapist is test which meniscus?
Lateral meniscus
A therapist is performing McMurray’s test on a patient. The therapist passively externally rotates the tibia while extending the knee with a valgus force. The therapist is test which meniscus?
Medial meniscus
A therapist is wanting to assess the angle of the femur and tibia (varus/valgus angle), where should the therapist measure to assess this angle.
- ASIS to the mid-point of the patella
- Mid-point of patella down the tibial shaft with goniometer
(Stable arm: pointed toward ASIS; AOR: Midpoint of patella, Moving arm: Tibial shaft)
A therapist is wanting to assess whether the patient is presenting with patellofemoral instability. What test should the therapist use?
Patellar apprehension test (knee flexed to 30 degrees, quads relaxed, therapists glides patella laterally)
Explain the 5 point scale used in conjunction with the Brush (Stroke) test for the knee.
0 = no wave produced on down stroke
1 (trace) = small wave
1+ = larger bulge
2+ = spontaneous return after upstroke
3+ = unable to move effusion out of medial knee
When is a pivot-shift positive?
(+) if tibia relocates during the test; as the knee is flexed, the tibia clunks backward at approximately 30-40 degrees
