Knee Special Tests

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74 Terms

1
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Primary = ACL

Secondary = MCL, LCL

Restraint(s): anterior translation

2
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Primary = PCL

Secondary = MCL, LCL

Restraint(s): posterior translation

3
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Primary = MCL

Secondary = ACL, PCL

Restraint(s): valgus rotation (medial gapping)

4
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Primary = LCL

Secondary = ACL, PCL

Restraint(s): varus rotation (lateral gapping)

5
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Primary = MCL, LCL

Secondary = Popliteus corner

Restraint(s): lateral rotation

6
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Primary = ACL, PCL

Secondary: Meniscofemoral ligaments

Restraint(s): medial rotation

7
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Taut, relaxed

During lateral rotation, the collateral ligaments are ________ (TAUT/RELAXED) & cruciate ligaments are _________ (TAUT/RELAXED)

8
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Taut, relaxed

During medial rotation, the cruciate ligaments are _________ (TAUT/RELAXED) & collateral ligaments are _________ (TAUT/RELAXED)

9
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MCL only

Instability: one-plane medial

10
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LCL only

Instability: one-plane lateral

11
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ACL only

Instability: one-plane anterior

12
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PCL only

Instability: one-plane posterior

13
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Medial meniscus, coronary ligament, OPL

Instability: anteromedial rotatory

14
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ACL, LCL, other soft tissue structures

Instability: anterolateral rotatory

15
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MCL, posterior oblique

Instability: posteromedial rotatory

16
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LCL, arcuate ligament complex

Instability: posterolateral rotatory

17
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MCL

Which ligament is tight t/o the entire ROM?

18
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LCL

Which ligament is tight during extension and loose in flexion (esp. after 30 degrees)?

19
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ACL

Which ligament prevents anterior movement of the tibia, checks lateral rotation, limits extension & hyperextension of knee?

20
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PCL

Which ligament is the STRONGEST ligament in the knee and functions as the primary stabilizer against posterior movement of the tibia on the femur?

21
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Abrupt & firm stop

Which end-feel is normal for the George Davies knee algorithm?

22
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Soft or indistinct end-feel

Which end-feel is abnormal for the George Davies knee algorithm?

23
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Sag sign -- PCL

Which special test is this? What does it test?

<p>Which special test is this? What does it test?</p>
24
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Tibia sags posteriorly

What is a (+) sag sign?

<p>What is a (+) sag sign?</p>
25
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Active drawer -- PCL

Which special test is this? What does it test?

<p>Which special test is this? What does it test?</p>
26
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Tibial plateau moves forward to its normal position, indicating that the tibia was previously posteriorly subluxated

What is a (+) active drawer test?

<p>What is a (+) active drawer test?</p>
27
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Posterior drawer -- PCL

Which special test is this? What does it test?

<p>Which special test is this? What does it test?</p>
28
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Lack of end feel or excessive posterior translation

What is a (+) posterior drawer?

<p>What is a (+) posterior drawer?</p>
29
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Anterior drawer -- ACL

Which special test is this? What does it test?

<p>Which special test is this? What does it test?</p>
30
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Lack of end feel or excessive anterior translation relative to contralateral side (normal translation is approx. 6 mm)

What is a (+) anterior drawer test?

<p>What is a (+) anterior drawer test?</p>
31
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Lachman's -- ACL (considered the BEST test for assessing the ACL)

Which special test is this? What does it test?

<p>Which special test is this? What does it test?</p>
32
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"Soft" or "mushy" end feel

What is a (+) Lachman's test?

<p>What is a (+) Lachman's test?</p>
33
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Valgus stress test @ 0 & 30 -- MCL

Which special test is this? What does it test?

<p>Which special test is this? What does it test?</p>
34
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Varus stress test @ 0 & 30 -- LCL

Which special test is this? What does it test?

<p>Which special test is this? What does it test?</p>
35
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Excessive laxity/gapping compared to the uninvolved side

What is a (+) valgus stress test?

36
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Excessive laxity/gapping compared to the uninvolved side

What is a (+) varus stress test?

37
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PCL -- if the PCL is torn, the tibia will sag backwards --> false (+) during ACL testing

Which ligament should you start w/ testing when suspicious of a ligamentous injury? Why?

38
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Active drawer (examiner sits on the pt's involved foot and instructs them to push their foot into your leg to see if it reduces)

If a sag sign is present, which test can you perform?

39
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Posterior drawer

If a sag sign is present, which test do you NOT need to perform bc it will be a false (-)?

40
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Lachman's

Which test is considered the BEST test for assessing the ACL?

41
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MAJOR disruption

If there is a (+) valgus stress test @ 0, what does this mean?

42
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More isolated assessment of one-plane medial instability

If there is a (+) valgus stress test @ 30, what does this mean?

43
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More isolated assessment of one-plane lateral instability

If there is a (+) varus stress test @ 30, what does this mean?

44
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Dial -- posterolateral rotary instability (LCL, arcuate ligament complex; posterolateral corner)

Which special test is this? What does it test?

<p>Which special test is this? What does it test?</p>
45
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Excessive rotation

What is a (+) dial test?

<p>What is a (+) dial test?</p>
46
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Pivot shift -- anterolateral (ACL, LCL, other soft tissue structures)

Which special test is this? What does it test?

<p>Which special test is this? What does it test?</p>
47
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Subluxation of the tibia while the femur rotates externally --> reduction of the tibia @ 30-40 degrees of flexion due to tightening of the IT band

What is a (+) pivot shift test?

<p>What is a (+) pivot shift test?</p>
48
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Jerk -- anterolateral (ACL, LCL, other soft tissue structures)

Which special test is this? What does it test?

<p>Which special test is this? What does it test?</p>
49
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At approx. 20-30 degrees of flexion, the tibia shift forward causing a subluxation of the lateral tibial plateau --> subluxation reduces in extension

What is a (+) jerk test?

50
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Slocum

- anterolateral w/ medial rotation

- anteromedial w/ lateral rotation

Which special test is this? What does it test?

<p>Which special test is this? What does it test?</p>
51
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Movement occurs primarily on the medial or lateral side of the knee

What is a (+) slocum test?

52
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McMurray

- lateral meniscus = medial rotation

- medial meniscus = lateral rotation

Which special test is this? What does it test?

<p>Which special test is this? What does it test?</p>
53
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Snap or click is often accompanied by pain

What is a (+) McMurray test?

54
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Apley's compression/distraction

- distraction = ligamentous

- compression = meniscus

Which special test is this? What does it test?

<p>Which special test is this? What does it test?</p>
55
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Distraction more painful or shows increased rotation --> ligamentous lesion

Compression more painful or shows decreased rotation --> meniscus injury

What is a (+) Apley's compression/distraction test?

56
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Thessaly -- meniscus

Which special test is this? What does it test?

<p>Which special test is this? What does it test?</p>
57
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Ege's

- medial meniscus = ER

- lateral meniscus = IR

Which special test is this? What does it test?

<p>Which special test is this? What does it test?</p>
58
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Pain and/or click

What is a (+) Ege's test?

59
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Effusion assessment

Which special test is this? What does it test?

<p>Which special test is this? What does it test?</p>
60
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Grade zero

Grade _____: no wave produced on downstroke

61
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Grade trace

Grade _____: small wave on medial side w/ downstroke

62
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Grade 1+

Grade _____: larger bulge on medial side w/ downstroke

63
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Grade 2+

Grade _____: effusion spontaneously returns to medial side after upstroke (no downstroke necessary)

64
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Grade 3+

Grade _____: so much fluid that it is not possible to move the effusion out of the medial aspect of the knee

65
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Patellar tilt -- patellofemoral pain syndrome

Which special test is this? What does it test?

<p>Which special test is this? What does it test?</p>
66
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Apprehension -- patellofemoral pain syndrome

Which special test is this? What does it test?

<p>Which special test is this? What does it test?</p>
67
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Moving out of the groove and subluxing laterally

What is a (+) patellar tilt?

68
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Reproduces patient's pain, apprehension

What is a (+) apprehension test?

69
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Waldron -- patellofemoral pain syndrome

Which special test is this? What does it test?

<p>Which special test is this? What does it test?</p>
70
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Crepitus and pain

What is a (+) Waldron test?

71
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Compression -- patellofemoral pain syndrome

Which special test is this? What does it test?

<p>Which special test is this? What does it test?</p>
72
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Reproduction of pain

What is a (+) compression test?

73
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Clarke or patellar grind -- patellofemoral pain syndrome

Which special test is this? What does it test?

<p>Which special test is this? What does it test?</p>
74
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Reproduction of pain

What is a (+) clarke or patellar grind test?