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KneeSpecialTest

Knee special tests from marys notebook

Special TestWhat does it test for?Patient positionclinician positionprocedurepositive test
Varus Stress Test -0 degrees ACL and LCL -at 30 degrees just LCL supine with legs close the edge of the table sitting on table, one hand supports the lateral portion of distaltibia, other hand holds knee along the medial joint line a varus force is applied to the knee and distal tibia is moved inward -increased laxity and decreased quality of the end feel when compared bilaterally
Lachmans ACL supine, knee passively flexed to 20-25 degrees one hand on the tibia at about the tibial tuberosity, with the other hand on the femur just above the condyles support the weight of the tibia is drawn anteriorly -increased anterior tibial translation when compared bilaterally -meaning there is a sprain or tear of the ACL
Slocum Lateral and medial joint capsule supine, with knee flexed to 90 degrees -tibia is internally rotated to 25 degrees -tibia is externally rotated to 15 degrees sitting on patients foot tibia is drawn anteriorly increased amounts of tibial translation when compared bilaterally -IR-anterolateral instability, ACL damage, anterolateral capsul, LCL, ITB, popliteus tendon, posterolateral capsule -ER anteromedial instability MCL damage, anteromedial capusle, ACL
Anterior Draw Test ACL supine, hip flexed to 45 degrees and kne to 90 degrees sitting on table infront of the injured knee, thumbs are along the joint line on both sides of the patella tendon make sure the hamstring tendons are relaxed, tibia is drawn anteriorly increased anterior tibial translation when compared bilaterally
Lateral pivot Shift ACL supine, hip passivelly flexed to 30 degrees lateral to patient, grabbing the lower leg or ankle, and ont hand supporting the knee internally rotate the tibia and apply a valgus force tibia will drop with flexion
Posterior Draw PCL supine with hip flexed to 45 degrees and knee flexed to 90 degrees sitting on exam table infront of involved foot, grap the tibia just below the joint line with their fingers along the joint line on either side of the patellar tendon push proximal tibia posterior increased posterior translation
Godfreys Test PCL supine with knee extended and legs together standing next tot he patient lift the patients lower legs near ankle and hold them parallel to the floor observe the levels of the tibial tuberosity knee should be at 90 degrees a unilateral posterior displacement of the tibial tuberosity
McMurays Test Meniscus Laying supine standing lateral and distal to patients knee, one hand supporting the lower leg, the thumb and index finger of the other hand on the joint line on both sides of the patella three passes, one in neutral position, one with tibia interally rotated an one with tibia externally rotated, each pass follows the same motion, apply a valgus force with knee flexed through ROM, then a varus stress applied while returning to extension poppin, clicking or locking of the knee, pain or sensaton similar to when originally injured
Apley's compression/distraction test meniscus prone with knee flexed to 90 degrees standing lateral to involved side compress-apply pressure to the plantar aspect of heal, applyin an axial load to the tibial while internally and externally rotating the tibia-Distraction-grasp lower leg, near the ankle, stabilize knee proximal to the femoral condyles, distract tibia pain is experienced during the compression portion but releived with distraction
Bounce home Meniscus/posterior capsule supine with legs extended lateral to the involved knee, one hand behind the knee one hand on the lower leg passively flex patients knee to about 30 degrees and remove hand from under knee no bounce on full.hyper extension
Obers Test IT Band lying on side opposit of being tested, with the knee being tested flexed, opposite leg hiop and knee maybe flexed standing behind patient, with one hand on the medial aspect of the proximal tibia abduct and extend the hip allowing the IT band/TFL to clear the greater trochanter, allow hip to passibely addcut to the table with knee kept straight un able to adduct past parallel to the table
Nobers Compression IT band tightness/syndrome supine with involved knee flexed Standing lateral to side being tested, support the knee above the joint line with thumb over the lateral femoral condyle, control leg with opposit hand apply pressure to the lateral femoral condyle and passibely extend and flex the knee pain is felt under clinician thumb, most commonly as knee approaches 30 degrees
Patellar apprehension patellar subluxation supine with knees extended and next to each other next to patient, one hand above the superior pole and hone hand below the inferior pole of the patella-index fingers are on the medial aspect of the patella apply lateral pressure to the patella making sure that thumbs are there incase of subluxation if the patella does not have a firm and point or no end point
Ballotable Patella Test Edema supine with knees extended standing next to patient apply a downward force to the patella the patella bounces back to original position
Sweep Test Swelling in joint capsule Supine with the knee extended Standing lateral to the patient stroke the medial portion of the knee proximally and laterally, until normal contour of the knee is restored, apply pressure on the lateral aspect of the knee reformation of edema on the medial side fo the knee when pressure is applied to the lateral aspect
Clarkes Sign Chondromalacia-produces a lot of false positives supine with knee extended lateral to the limb being tested, on hand proximal to the superior pole of the patella, applying a gental downard pressure have patient contract quads while pressure is maintained on the peta pushing it into the femoral trochlea Patellafemoral pain and the inabilitiy to hold the contraction
Stutter Test medial synovial plica sitting with knee flexed over the edge of the table standing lateral to the involved side, lightly cupping one hand over the patella makeing sure not to compress articular surfaces have patient slowly actibely extend the knee irrecular motion or stuttering between 40 and 60 degrees as the plica passes over the medial condyle
Wilson Test Osteochondral defects of the knee sitting with knee flexed to 90 degrees and tibia internally rotated in front of patient to observe any secondary reactions patient actively extends thier knee while maintaining IR and stops when pain is experienced and holds it in that position, if pain is experienced they are asked to ER the tibia while knee is in same point of flexion pain is experienced when tibia is IR but releaved by ER
Valgus Stress test -0 degrees ACL and MCL -30 degrees just MCL supine with legs close to the edge of the table standing lateral to limb, one hand on the medial portion of the distal tibia, other hand holding knee along the lateral joint line apply a medial or valgus force to the knee while moving distal tibia lateral -increased laxity and decreased quality of the end point with bilateral comparision -sprain or possible trear of the MCL/ACL
Created by: jwebst1