Ligament Tests Flashcards
What constitutes a positive Valgus test?
Reproduction of medial knee pain and/or laxity on testing. End feel should be ligamentous - i.e. firm resistance to test
How do you perform the valgus test?
Patient in supine, leg relaxed.
Heel of outside hand is placed above lateral joint line, inside hand placed just below medial joint line. Patient’s leg is supported between waist and elbow, knee flexed to 20-30o and hip in some internal totatin and abduction
Firm inwards pressure applied with outside hand and outwards pressure with inside hand while rotating body away from the couch.
What does a positive valgus test mean?
Medial knee pain alone - MCL injury
Medial knee pain and loss of normal end-feel - more serious MCL injury which is likely to involve other structures
How do you perform the varus test?
Patient - supine towards edge of couch
Clinician - On affected side, leg is abducted, supported between waist and elbow of outside hand. Hip is in some internal rotation (knee pointing outwards)
Hands - Heel of outside hand below lateral joint line, inside hand just above medial joint line
Action - Knee in 20o flexion firm pressure applied with both hands whilst rotating body away from couch
What is a positive varus test?
Lateral knee pain and/or laxity
What does a positive varus test indicate?
LCL injury
How do you perform a posterior drawer test?
Patient - supine, hip and knee flexed so that foot is flat on couch.
Clinician - sitting on dorsum of foot of affected LL both hands around tibia (below joint line) thumbs placed anteriorally on joint line.
Action - Tibia is pushed backwards with both hands quality of joint end feel should be noted
What is a positive posterior drawer test?
Increased posterior movement of the tibia and loss of ligamentous “stop” end feel.
What does a positive posterior drawer test indicate?
PCL injury/laxity
How do you perform an anterior drawer test?
Patient: Supine with foot flat on couch
Clinician: Sitting on dorsum of foot on affected side, hands around upper tibia, thumbs anteriorly
Action: Tibia is drawn forwards with both hands and compared to other side. Quality of end feel should also be noted
What is a positive anterior drawer test?
Increased anterior movement of the tibia and loss of the normal ligamentous “stop” end feel.
What does a positive anterior drawer test indicate?
ACL injury/laxity
How do you perform Lachman’s Test?
Patient: Supine
Clinician - foot is stabilised between thigh and couch.
Hands: Outside hand placed over lateral aspect of thigh above knee and fingers around the back of the thigh. Inside hand is placed over medial aspect of knee just below joint line and knee in 10-30o of flexion
Action: Outside hand stabilising, lower hand pulls tibia forward and the quality of the end feel should be noted
What is a positive Lachman’s test?
Increased anterior movement of the tibia and lack of ligamentous “stop” end feel.
What does a positive Lachman’s test indicate?
ACL injury/laxity
