Special Test Patient’s Position Physical Therapy Procedure Positive Sign Significance

Position

Adduction/Varus Stress Test
Supine -Standing beside the legs -PT pushes the knee Excessive gapping in the One-plane instability,the
of the patient laterally while the ankle is lateral side in the knee following structures may
-the hand or with the leg stabilized. knee is flexed joint and pain have been injured to some
held between the 20° to 30°with lateral degree:
examiner’s arm and trunk rotation of the tibia 1. Lateral collateral ligament
2.Posterolateral capsule
3.Arcuate-popliteus complex
4. Iliotibial band
5. Biceps femoris tendon

Abduction/ Valgus Stress Test
Supine -Standing beside the legs -PT pushes the knee Excessive gapping in the One-Plane Instability, the
of the patient medially while the ankle is medial aspect of the following structures may
-the hand or with the leg stabilized. knee is flexed knee joint and pain have been injured to some
held between the 20° to 30°with medial degree:
examiner’s arm and trunk rotation of the tibia 1. Medial collateral ligament
(superficial and deep fibers)
2. Posterior oblique ligament
3.Posteromedial capsule
4. Anterior cruciate
ligament5. Posterior cruciate
ligament6. Medial
quadriceps expansion7.
Semimembranosus muscle

Lachman’s Test Supine Standing beside the legs -The patient’s femur is Mushy or Soft end feel One-Plane Anterior
Other names: of the patient stabilized with one of the when the tibia is moved Instability;the following
● Ritchie examiner's hands (the forward on the femur structures may have been
● Trillat “outside” hand) while the (increased anterior injured to some degree:
● Lachman-Trillat Test proximal aspect of the tibia translation with medial 1. Anterior cruciate ligament
is moved forward with the rotation of the tibia) and (especially the posterolateral
other(“inside”) hand. disappearance of the bundle)
-PT hols the pt’s knee infrapatellar tendon slope 2. Posterior oblique ligament

Lachman Test (MODIFICATION 1)
Stable Lachman Test
(MODIFICATION 2)
Drop Leg Lachman Test
(MODIFICATION 3)
Lachman Test (MODIFICATION 4)
Lachman Test (MODIFICATION 5)
Sitting with the leg The examiner sits facing
over the edge of the the patient and supports
examining table the foot of the test leg on
the examiner’s thigh so
that the patient's knee is
flexed 30°.
Supine with knee Standing with one knee
resting on the PT’s flexed resting on the
knee lateral side of the table
Supine and the leg Standing facing the
to be examined is patient
abducted of the side
of the examining
table;knee flexed to
25°.
Supine Examiner stabilizes the
foot between the
examiner’s thorax and
arm.
Supine Examiner stands beside
between full extension and *False Negative: the 3. Arcuate-popliteus
30 degrees flexion femur is not properly complex
stabilized, if a meniscus
lesion blocks translation,
or if the tibia is medially
rotated.
-Stabilize the thigh with Abnormal forward motion One-Plane Anterior
one hand and pull the tibia Instability
forward with the other
hand.
Examiner’s hand stabilizes Abnormal forward motion One-Plane Anterior
the femur against the Instability
examiner’s thigh and the
other hand applies an
anterior stress.
Examiner’s hands stabilize Greater Anterior Laxity One-Plane Anterior
the femur against the table Instability
while the patient’s foot is
held between the
examiner’s knees. The
examiner’s other hand is
the free to apply the
anterior translation force
Both hands are placed Abnormal forward motion One-Plane Anterior
around the tibia,the knee is Instability
flexed 20° to 30°, and an
anterior drawer movement
is performed.
Examiner grasps the femur Abnormal forward motion One-Plane Anterior

Prone Lachman Test
(MODIFICATION 6)
Active (no touch) Lachman Test
(MODIFICATION 7)
Active Lachman (Maximum
Quadriceps) Test (MODIFICATION
8)
Drawer Sign
Other name:
● Anterior Drawer Test
the leg to be tested with with one hand and the tibia Instability
the eyes level with the pulled forward with the
knee. other hand.
Prone Examiner stabilizes the One hand around the tibia Abnormal forward motion One-Plane Anterior
foot between the and the other hand Instability
examiner’s thorax and stabilizes the femur.
arm
Supine with the Standing on the lateral The patient is asked to anterior displacement of One-Plane Anterior
knee over the side of the examining actively extend the knee, the tibia relative to the Instability
examiner’s forearm table unaffected side
so that the knee is
flexed
approximately 30°
Supine with the Standing on the lateral The patient is asked to anterior displacement of One-plane Anterior
knee over the side of the examining actively extend the knee the tibia relative to the Instability
examiner’s forearm table while putting resistance unaffected side
so that the knee is on********
flexed
approximately 30°
Supine; pt's knee is Sitting on the examining hands are placed around Tibia moves forward One-plane anterior and One-
flexed to 90°; hip table at the patient’s the tibia to ensure that the more than 6mm on the plane Posterior Instability;
flexed to 45° forefoot side hamstring muscles are femur the following structures may
relaxed.The tibia is then have been injured to some
drawn forward on the degree:
femur 1. Anterior cruciate ligament
(especially the anteromedial
bundle)
2. Posterolateral capsule
3. Posteromedial capsule
4. Medial collateral ligament
(deep fibers)
5. Iliotibial band

Active Drawer Test
Other name:
● Quadriceps Active Test
90-90 Anterior Drawer Test
Sitting Anterior Drawer Test
Posterior Sag Sign
Other Name: Gravity Drawer Test
Slocum Test
6. Posterior oblique ligament
7. Arcuate-popliteus
complex
Supine with knee Examiner holds the pt’s Patient is asked to try to
flexed foot down/ straighten the leg, and the
examiner prevents the
patient from doing so
(isometric test)
Supine Examiner is on top of the The examiner flexes the An audible snap or ACL torn
bed, kneeling patient’s hip and knee to palpable jerk (Finochietto
90° and supports the lower jumping sign)
leg between the examiner's Tibia is pulled forward
trunk and forearm. The and it moves forward
examiner places the hands excessively
around the tibia, as with
the standard test, and
applies sufficient force to
slowly lift the patient’s
buttock off the table.
Sitting with the leg Sitting facing the patient Examiner places the hands
hanging relaxed as with the standardized
over the end of the test and slowly draws the
examining table tibia first forward and then
backward to test the
anterior and posterior
drawer
supine with the hip
flexed to 45° and
the knee flexed to
90°.
Supine;knee is Standing facing the The examiner then sits on Movement primarily on Anterior Rotary Instabilities

Godfrey (Gravity) Test
Active Pivot Shift test
Loomer’s Posterolateral Rotary
Instability Test
flexed to 80°or 90°, patient the patient’s forefoot to the lateral side of the the following structures may
and the hip is flexed hold the foot in position knee have been injured to some
to 45°. The foot is and draws the tibia forward degree:
first placedin 30° 1. Anterior cruciate ligament
medial rotation 2. Posterolateral capsule
3. Arcuate- popliteus
complex
4. Lateral collateral ligament
5. Posterior Cruciate
ligament
6. Iliotibial band
Supine Standing on the lateral examiner holds both legs Posterior Sag of the tibia Posterior Instability
side of the examining while flexing the patient's
table hips and knees to 90°
patient sits with Sitting at the lateral side the patient is asked to abnormal (excessive) Anterolateral instability
thefoot on the floor of the affected area of the isometrically contract the anterior rotation of the
in neutral rotation patient quadriceps while the tibia on the lateral side
and the knee examiner stabilizes the relative to the femur.
flexed80° to 90° foot.
supine and flexes Standing at the foot end examiner then grasps the injured tibia laterally Posterolateral rotary
both hips and both of the patient(???) feet and maximally laterally rotates excessively and instability
knees to 90°. rotates both tibias there is a posterior sag of
the affected tibial tubercle