Special Test Knee

Question 1

In the classical way, the
examiner holds the
patient’s knee in between
full extension and 30
degrees flexion. Stabilize
femur with one hand.

Answer 1

Classic Lachman Test

Question 2

the patient is sitting with the leg
over the edge of the examining table. The examiner supports the
patient’s leg with his thigh so that the knee is flexed @30 degrees.

Answer 2

Modification 1

Question 3

For examiners with small hands, the patient
rests his knee on the examiner’s knee. One hand
of the examiner stabilizes the femur against his thigh
and the other applies anterior stress.

Answer 3

Stable Lachman or Modification 2

Question 4

The leg to be examined is abducted off the side of the examining
table and the knee is flexed to 25 degrees. One hand stabilizes the femur while the other applies anterior force. It was said that this modification produces greater anterior laxity.

Answer 4

Drop Leg Lachman Test or Modification 3

Question 5

The examiner stabilizes the foot
between the examiner’s thorax and arm. Both hands
are placed on the tibia and the knee is flexed @ 20-30 degrees. Then, an anterior drawer movement is performed.

Answer 5

Modification 4

Question 6

the examiner stands beside the
test leg. The examiner stabilizes the femur with
one hand and the tibia with the other. The tibia is then
pulled forward and any abnormal motion is noted

Answer 6

Modification 5

Question 7

The patient lies prone and stablizes the
foot between the examiner’s thorax and arm.
One hand stabilizes the femur and another is around the tibia.

Answer 7

Prone Lachman Test or Modification 6

Question 8

the patient places his knee over the examiner’s
forearm so that it is approximately flexed
@ 30 degrees. The patient is then asked to actively extend the knee.

Answer 8

Active Lachman Test or Modification 7

Question 9

It has a similar the procedure with the previous
modification, but the foot is held down on the table.

Answer 9

Maximum Quadriceps Test or Modification 8

Question 10

1. The examiner stabilizes the ankle, and the knee is fully
   extended (method 1)
2. externally rotated or flexed @ 20-30 degrees (method 2)
3. It can also be done with the knee extended while
   grasping the patient’s big toe and applying valgus
   force (Hughston’s valgus stress test/method 3)

Answer 10

Abduction Test/ Valgus Stress Test

Question 11

1. The examiner stabilizes the ankle and the knee is fully
   extended. (method 1)
2. flexed @ 20-30 degrees (method 2)
3. It can also be done with the knee extended while
   grasping the patient’s fourth and fifth toe and applying
   valgus force (Hughston’svalgus stress test/method 3)

The examiner then applies a varus force to the knee

Answer 11

Adduction Test/ Varus Stress Test

Question 12

1. The examiner’s knee is positioned @ a 45-degree
   angle.
2. The examiner golds the patient’s foot down. The patient is then asked to straighten the leg while the examiner prevents him actively.

Answer 12

Active Drawer Test or Quadriceps Active Test

Question 13

1. The patient’s knee is passively flexed to 90
   degrees and hip is flexed to 45 or 90 degrees.
2. The examiner then draws the tibia anteriorly.

Answer 13

Drawer Sign

Question 14

The examiner holds both legs while flexing the
patient’s hip and knee to 90 degrees.

Answer 14

Godfrey Test or Gravity Test

Question 15

The patient’s hip is flexed to 45 degrees and the knee is
flexed to 90 degrees. This position promotes the tibia
“drops back” or sags back on the femur because of gravity.

Answer 15

Posterior Sag Sign (Gravity Drawer Test)

Question 16

The examiner holds the patient’s leg in an extension
with one arm against the body and the hand under
the calf to lift the tibia while applying a valgus stress

Answer 16

Dejour Test

Question 17

1. The patient’s knee is flexed to 80 or 90 degrees and the hip is flexed to 45 degrees.
2. The patient’s foot is first placed in 30 degrees medial rotation and then the examiner sits on the patient’s forefoot and draws
   the tibia forward.

Answer 17

Slocum Test

Question 18

1. The patient sits with the foot on the floor in neutral
   rotation and the knee flexed to 80 or 90 degrees.
2. The patient is asked to contract the
   quadriceps while the examiner stabilizes the foot isometrically.

Answer 18

Active Pivot Shift Test

Question 19

1. The examiner flexes the patient’s hip to 45 degrees
   and the knee to 90 degrees.
2. The examiner then applies a valgus force to the knee
   while simultaneously extending the knee

Answer 19

Jerk Test of Hughston

Question 20

1. The patient lies supine with the hip both flexed and
   abducted to 30 degrees and relaxed in slight IR @ 20 degrees
2. The examiner golds the patient’s foot with one hand
   while the other is placed at the knee, holding the leg in slight IR.
3. The examiner applies a valgus force to the knee while simultaneously flexing the knee.

Answer 20

Lateral Pivot Shift Maneuver (Test of Macintosh)

Question 21

1. The patient’s knee is flexed to 80-90 degrees, and the
   hip is flexed to 45 degrees.
2. The examiner medially rotates the patient’s foot
   slightly and sits on the foot to stabilize it. The
   examiner then applies a posterior force on the tibia.

Answer 21

Hughston’s posteromedial and posterolateral drawer sign.

Question 22

1. The patient lies prone with the knee flexed to 90 degrees. The
   patient’s thigh is then anchored to the examining table with the
   examiner’s knee.
2. The examiner medially and laterally rotates the tibia,
   combined with distraction while noting any restrictions,
   excessive movement or discomfort.

Answer 22

Appley’s Test

Question 23

1. The examiner’s hand cupped the patient’s heel, with the
   patient’s knee completely flexed. Then, the knee is allowed to extend passively

Answer 23

Bounce Home Test

Question 24

1. The patient lies supine with the knee was completely flexed.
2. The examiner then medially rotates the tibia and extends
   the knee.

Answer 24

McMurray Test

Question 25

1. The examiner flexes the patient’s knee to 90 degrees,
   rotates it medially and laterally twice, and then fully flexes and rotates it both ways again

Answer 25

O’Donohue’s Test

Question 26

1. The patient lies supine and the examine flexes the patient’s
   knee and medially rotates the tibia with one arm while
   pressing the patella medially with the heel of the the other
   hand and palpating the medial femoral condyle.
2. Te patient’s knee is then passively flexed and extended
   while the examiner feels for popping.

Answer 26

Hughston’s Plica Test

Question 27

1. The examiner commences the stroking just below the joint line
   on the medial side of the the patella, stroking proximally
   towards the patient’s hip two or three times.
2. With the opposite hand, the examiner strokes down on the lateral side of the patella.

Answer 27

Brush, Stroke, or Bulge Test/ Wipe Test

Question 28

With the patient’s knee extended or flexed to discomfort, the examiner applies a slight tap or pressure over the patella.

Answer 28

Patellar Tap Test (Ballotable Patella)

Question 29

1. The examiner pressed down on the patella with the web of
   the hand.
2. The patient is then asked to contract the quadriceps
   muscles while the examiner pushes down.

Answer 29

Clarke’s Sign

Question 30

1. The patient performs isometric quadriceps
   contractions @ 120, 90, 60, 30, and 0 degrees with
   each contraction is held for 10 seconds.
2. If pain is produced at any angle, the examiner places
   a medial glide towards the patella, and the patient
   performs isometric quadriceps contraction again.

Answer 30

Mcconnel Test for Chondromalacia Patellae

Question 31

1. The patient stands beside a stool that is 25 cm (10 in.)
   high.
2. The examiner asks the patient to step up sideways
   onto the stool using the good leg. The test is repeated with the other leg.
3. Normally, the patient should have no difficulty doing the
   test and have no pain

Answer 31

Step-up Test

Question 32

The examiner palpates the patella while asking the
patient to perform several slow deep knee bends.

Answer 32

Waldron’s Test (Squat Test)

Question 33

The patient lies supine with quads relaxed and knee flexed
to 30 degrees while the examiner slowly pushes the
patella laterally and distally.

Answer 33

Fairbank’s Apprehension Test

Question 34

The examiner selects areas where muscle bulk or swelling
is greatest and measures the circumference of the leg.

The following are the common measure points:
● 15 cm (6 in) below the apex
of the patella
● Apex of the patella or joint
line.
● 5 cm (2 in) above the base
base of patella
● 10 cm (4 in) above the base
of patella
● 15 cm (6 in) above the base
of the patella
● 23 cm (9 in) above the base
of the patella

Answer 34

Measurement of Muscle Bulk/ Anthropometric Measurement’s For Efussion and Atrophy