The Anterior Drawer Test for the knee is used to examine the integrity of the anterior cruciate ligament. The patient is placed supine on the table with the knee in 90 degrees of flexion and the hip flexed approximately 45 degrees. The examiner places her hands around the proximal tibial with her thumbs crossing the anterior joint line. The patient's foot is anchored in a neutral position by the examiner's thigh. The examiner tells the patient to relax her hamstrings. This suggestion is enhanced through a light tapping with the examiners fingers on the tendons of the hamstrings just behind the knee. Once the patient is relaxed the examiner attempts to pull the tibia anteriorly. Instability is determined by examining bilaterally and comparing the amount of excursion present.
Tuesday, May 29, 2007
Apley's distraction test is commonly performed in conjunction with Apley's compression test. The patient starting position is the same (prone with the knee flexed to 90 degrees). The examiner will apply traction to the lower leg while rotating the tibia medially and laterally. Pain with this maneuver can indicate a ligamentous injury of the knee.
Apley's Compression test is used to assess the menisci of the knee. The patient is place prone on the exam table with her knee flexed to 90 degrees. The examiner applys a downward compressive force through the lower leg while laterally rotating the lower leg. Pain with this maneuver can indicate an injury of either meniscus.