Sports Medicine II
Knee Special Tests
Name _______________________
Anterior Drawer Test
Patient Position
lying supine; hip flexed to 45º to 90º
Examiner Position
sitting on the examination table in front of the involved knee
Procedures
1. Grasp the tibia just below the joint line of the knee. Thumbs placed along joint
line on either side of the patellar tendon. Index fingers used to palpate the
hamstring tendons to ensure they are relaxed.
2. Tibia drawn anteriorly
Positive Test
increased amount of anterior tibial translation compared with the opposite limb or lack of
firm end point
Implications
sprain or tear of ACL
Lachman’s Test
Patient Position
lying supine, knee passively flexed to 20º-25º
Examiner Position
standing distal and lateral to involved limb
Procedures
1. Grasp tibia around the level of the tibial tuberosity while the other hand grasps the
femur above the level of the condyles
2. Examiner Knee flexed to 20º and support the weight of the leg
3. Tibia is drawn anteriorly while a posterior pressure is applied to stabilize the femur
Positive Test
increased amount of anterior tibial translation compared with the opposite limb or lack of
firm end point
Implications
sprain of ACL
Posterior Drawer Test
Patient Position
lying supine, hip flexed to 45º and knee flexed to 90º
Examiner Position
sitting on the examination table in front of the involved knee
Procedures
Positive Test
1. Stabilize tibia in neutral position
2. Grasp tibia below the joint line of the knee with fingers placed along the joint line
on either side of the patellar tendon
3. Push tibia posteriorly
increased amount of posterior tibial translation compared with the opposite limb or lack of
firm end point
Implications
sprain of PCL
Godfrey’s Test
Patient Position
lying supine with knees extended and legs together
Examiner Position
standing next to paitent
Procedures
1. Lift patient’s lower legs and hold them parallel to the table so that the knees are
flexed to 90º
2. Observe the level of the tibial tuberosities
Positive Test
posterior displacement of the tibial tuberosity
Implications
sprain of PCL
Valgus Stress Test/Varus Stress Test
Patient Position
lying supine with the involved leg close to the edge of the table
Examiner Position
valgus: standing lateral to the involved limb
varus: sitting on table
Procedures
Valgus:
1. One hand supports medial portion of distal tibia while other hand grasps the knee
along the lateral joint line.
2. Medial force applied to the knee while distal tibia is moved laterally
3. Test performed in extension and flexed to 25º
Varus:
1. Support lateral portion of distal tibia with one hand while the other hand grasps the
knee along the medial joint line
2. Lateral force applied to knee while distal tibia is moved inward
3. Test performed in extension and flexed at 25º
Positive Test
increased laxity, decreased quality of the end point, pain compared with the uninvolved
side
Implications
valgus: in extension- sprain of the MCL, medial joint capsule, cruciate ligaments
flexed- sprain of MCL
varus: in extension-sprain of LCL, lateral joint capsule, cruciate ligaments
flexed-spain of LCL
McMurray’s Test
Patient Position
lying supine
Examiner Position
standing lateral and distal to the involved knee
Procedures
1. One hand supporting lower leg while thumb and index finger of opposite hand are
positioned on either side of the joint line
2. PASS ONE: tibia remains in neutral position. Valgus stress applied while knee is
flexed through ROM. Varus stress applied while knee is extended
3. PASS TWO: tibia internally rotated. Valgus stress applied while knee is flexed
through ROM. Varus stress applied while knee is extended.
4. Pass THREE: tibia externally rotated. Valgus stress applied while knee is flexed
through ROM. Varus stress applied while knee is extended
Positive Test
popping, clicking, or locking of knee, pain emanating from menisci
Implications
meniscal tear
Aplye’s Compression and Distraction Test
Patient Position
lying prone with knee flexed to 90º
Examiner Position
standing lateral to the involved side
Procedures
1. Apply pressure to the plantar aspect of the heel while internally and externally
rotating the tibia
2. Grasp lower leg and stabilize proximal knee. Distract lower leg away from femur
while internally and externally rotating the tibia
Positive Test
pain during compression that is reduced or eliminated during distraction
Implications
meniscal tear
Noble’s Compression Test
Patient Position
lying supine with the knee flexed
Examiner Position
standing lateral to the side being tested
Procedures
Positive Test
1. Support knee above the joint line with the thumb over or just superior to the lateral
femoral condyle. Use opposite hand to control lower leg.
2. Passively extend and flex knee while applying pressure over the lateral femoral
condyle.
pain under thumb, especially as knee approaches 30º
Implications
inflammation of IT band, bursa, or lateral femoral condyle
Ober’s Test
Patient Position
lying on the side opposite that being tested with the tested knee in flexion
Examiner Position
standing behind the patient; grasp involved leg along the medial aspect of the proximal
tibia
Procedures
1. Abduct and extend the hip to allow the TFL to clear the greater trochanter.
2. Allow hip to passively adduct to the table
Positive Test
leg is unable to adduct past parallel
Implications
tightness of the IT band, predisposing individual to IT band friction syndrome and/or
lateral patellar malalignment