Knee

Question 1

Anterior Drawer

Answer 1

• test the integrity of the ACL
• positive with excessive anterior translation of the tibia

Question 2

pt and PT position in the anterior drawer

Answer 2

pt: in supine with hip flexed to 45 and knee flexed to 90
PT: hands on posterior tibia and stabilizing the foot translating tibia anteriorly

Question 3

Lachmans test

Answer 3

• gold standard test for the integrity of the ACL
• positive with excessive tibia translation compared to the other side

Question 4

pt and PT position in Lachmans test

Answer 4

pt: supine with knee flexed to about 20-30 degrees
PT: hands on the posterior tibia and stabilizing the foot provide an anterior translation of the tibia

Question 5

Lellis test

Answer 5

• used to test a grade 3 ACL tear
• positive with lack of anterior motion of the tibia

Question 6

Lellis test pt and PT position

Answer 6

pt: supine with towel under the lower leg
PT: provide a posterior force onto the femur

Question 7

Posterior Drawer

Answer 7

• test the integrity of the PCL
• Positive with excessive posterior translation

Question 8

posterior drawer pt and PT position

Answer 8

pt: supine with hip flexed to 45 and knee flexed to 90
PT: stabilize the foot, hands on anterior tibia giving a posterior glide

Question 9

posterior sag sign

Answer 9

• test the integrity of the PCL
• positive with a sag or loss of “step”

Question 10

posterior sag pt and PT position

Answer 10

pt: supine hip flexed to 45 degrees and knee flexed to 90
PT: stabilize at the ankle and at the distal femur

Question 11

Valgus stress test at 0

Answer 11

• indicates a grade 2/3 MCL tear
• positive with laxity or reproduction of pain

Question 12

pt and PT position with valgus stress test at 0

Answer 12

pt: supine IR of tibia
PT: one hand on ankle controlling tibial ER and giving valgus force (abduction) the other hand supporting lateral femur

Question 13

Valgus stress test in 20-30 degrees of flexion

Answer 13

• tests the integrity of the MCL grade 1/2
• positive with increase laxity or reproduction of pain

Question 14

pt and PT position with the valgus stress test at 20-30 degrees

Answer 14

pt: in supine knee bent to 20-30 degrees tibia in ER
PT: one hand at ankle providing tibia ER and abduction of the leg. the other hand supporting the distal femur

Question 15

varus stress test at 0 degrees

Answer 15

• used to test the integrity of the LCL grades 2/3
• positive with increased laxity or reproduction of pain

Question 16

pt and PT position for a varus stress test at 0 degrees

Answer 16

pt is in supine.
PT: one hand at ankle providing IR and adduction of the tibia. the other hand supporting the distal femur.

Question 17

pivot shift test

Answer 17

• used to test the ACL, anterolateral instability, rotational instability
• positive if tibia relocates backward 30-40 accompanied by a “clunk” or “giving way”

Question 18

pt and PT position in the pivot test

Answer 18

pt: supine, knee in extension, hip flexed/abducted to 30 degrees with internal rotation
PT: hold lateral calcaneous to introduce IR and second hand at fibia head to give a valgus force. move the knee into flexion from extension

Question 19

mcmurrays test with IR

Answer 19

• used to test the lateral meniscus
• positive with a reproduction of a click and/or pain at the joint line

Question 20

pt and PT position in the mcmurrys test with IR

Answer 20

pt: supine starting with knee all the way flexed
PT: hand on the lateral ankle providing IR other hand on the knee joint controlling extension

Question 21

mcmurray test with ER

Answer 21

• used to test the integrity of the medial meniscus
• positive with a click and/or reproduction of pain at joint line

Question 22

pt and PT position in mcmurrays test with ER

Answer 22

pt: supine with knee flexed all the way
PT: hand on medial ankle providing external rotation of the tibia. other hand on the joint line controlling knee into extension.

Question 23

Thessaly

Answer 23

used to test the integrity of the meniscus

Question 24

pt and PT position for thessaly

Answer 24

pt: SLS with slight bend in the knee rotating medially and laterally
PT: provide UE support for pt.

Question 25

patellar apprehension

Answer 25

- used to detect patellofemoral instability - positive with pt apprehension or quad contraction

Question 26

pt and PT position in patellar apprehension test

Answer 26

pt: supine with 30 degrees fo knee flexion PT: passively translate the patella laterally

Question 27

clarkes sign/ patellar grind

Answer 27

- used to test patellofemoral instability/ lateral tracking issues - positive with reproduction of pain or inability to hold QS for 2 secs

Question 28

pt and PT position in clarkes sign

Answer 28

- pt supine hold quad set - pt: provides an inferior glide to the patella

Question 29

Noble compression

Answer 29

- used to test for ITB (tendonitis/osis) - positive for a reproduction of pain at the lateral femoral condyle

Question 30

pt and PT position for noble compression

Answer 30

pt: supine knees flexed to 90 PT: provides pressure 1-2 cm from lateral femoral condyle and passively extending the knee.

Question 31

stroke test

Answer 31

- used to test edema of the patella - positive with fluid observed on medial knee 0= no wave 1+ buldge on medial knee 2+ spontaneous return after stroke 3+ pitting edema

Question 32

pt and PT position in the stroke test

Answer 32

pt: supine knees extended PT: glide fingers upward at medial tibiofemoral joint then glide fingers downward on distal lateral thigh

Question 33

Apleys compression and distraction

Answer 33

- used to detect meniscus injuries

Question 34

pt and PT postion in Apleys

Answer 34

- pt prone with knee flexed to 90 - PT providing compression with IR and ER and distraction with IR and ER