Orthopedic test for the Knee
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This document describes several orthopedic tests used to evaluate the knee. It summarizes the Brush Test, Ballotable Patella Test, and Clarke's Test used to check for knee effusion and patellofemoral dysfunction. It also outlines the Anterior Drawer Test, Posterior Drawer Test, and Posterior Sag Sign used to evaluate injuries to the ACL and PCL. Additionally, the Valgus Stress Test, Varus Stress Test, Apley's Compression Test, and McMurray Test are described to assess injuries to the MCL, LCL, meniscus, and ligaments. Each test lists the positioning, motion, and expected findings to indicate a positive result.
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Orthopedic test for the Knee
- 1. PRESENTATION ON ORTHOPEDIC TEST FOR THE KNEE By Umofia Aniekan Imoh 2nd June, 2022.
- 2. Brush Test Pt in supine with knee supported on the table and slightly flexed. PT places one hand below the joint line on the medial surface of the patella and strokes proximally with the palm and fingers as far as the suprapatellar pouch. The other hand then strokes down the lateral surface of the patella. (+) wave of fluid just below the medial distal border of the patella. Indicates knee effusion.
- 3. Ballotable Patella Pt in supine with the knee extended on table. PT applies a slight tap over the center of the patella. (+) patella appears to be floating ("dancing patella" sign). Indicates retro-patellar effusion
- 4. Clarke’s Test Pt in supine with knee extended on table. PT applies slight posterior pressure with the web space of their hand over the superior pole of the patella while PT instructs the pt to contract the quadriceps muscle. (+) pain upon contraction. Indicates patello-femoral dysfunction.
- 5. Anterior Drawer Test Pt in supine with the knee flexed to 90 degrees and the hip flexed to 45 degrees. PT stabilizes the lower leg by sitting on the forefoot and grasps the patient's proximal tibia with both hands placing the thumbs on the tibial plateau. PT administers an anterior directed force to the tibia on the femur. (+) excessive anterior translation of the tibia on the femur with a diminished or absent end- point. Indicates ACL injury.
- 6. Posterior Drawer Test Pt in supine with the knee flexed to 90 degrees and the hip flexed to 45 degrees. PT stabilizes the lower leg by sitting on the forefoot and grasps the patient's proximal tibia with both hands placing the thumbs on the tibial plateau. PT administers an posterior directed force to the tibia on the femur. (+) excessive posterior translation of the tibia on the femur with a diminished or absent end- point. Indicates PCL injury.
- 7. Posterior Sag Sign pt in supine with knee flexed 90 deg. & hip flexed 45 deg. PT observes position. (+) tibia "sags" posterior. Indicates PCL injury.
- 8. Valgus Stress Test Pt in supine with entire LE supported and knee flexed to 20-30 deg. PT places one hand on medial surface of ankle and other hand on lateral surface of knee. PT applies valgus force to the knee with distal hand. (+) excess valgus movement and/or pain. Indicates MCL sprain. Note: a (+) test with knee in full extension may be indicative of damage to MCL, PCL, posterior oblique ligament, posteromedial capsule
- 9. Varus Stress Test pt in supine with entire LE supported and knee flexed 2030 deg. PT places one hand on lateral surface of ankle and other hand on medial surface of knee. PT applies varus force to knee with distal hand. (+) excess varus movement and/or pain. Indicates LCL sprain. NOTE: a (+) test with knee in full extension may be indicative of damage to LCL, PCL, poterolateral capsule
- 10. Apley’s Compression Test Pt in prone with knee flexed 90 deg. PT stabilizes femur with PT's hand. PT passively distracts the knee joint then slowly rotates tibia internally and externally then apply a compressive force through tibia while continuing the rotation of the tibia. (+) pain/clicking or decreased motion during compression indicates meniscal dysfunction. (+) pain/clicking or decreased motion during distraction indicates ligamentous dysfunction.
- 11. McMurray Test Pt in supine with knee in full extension. PT grasps distal leg with one hand and palpates knee joint line with other. PT medially rotates tibia and extends knee. Repeat same while laterally rotating tibia. (+) pain &/or click over joint line. Indicates dysfunction in lateral meniscus with passive IR of tibia and medial meniscus with ER of tibia