A.LIGAMENTOUS INSTABILITY: 1.Anterior drawer test 2.Lachman test 3.Lateral pivot shift test 4.Posterior drawer test 5.

Posterior sag sign 6.Slocum test 7.Valgus stress test 8.Varus stress test

1. Apley's compression test 2. Bounce home test 3. McMurray test

1. Brush test, 2. Patellar tap test

1. 2. 3. 4.

Clarke's sign Hughston's plica test Noble compression test Patellar apprehension test

The patient is positioned in supine with the knee flexed to 90 degrees and the hip flexed to 45 degrees. The therapist stabilizes the lower leg by sitting on the forefoot. The therapist grasps the patient's proximal tibia with two hands and places their thumbs on the tibial plateau and administers an aterior directed force to the tibia on the femur. A positive test is indicated by excessive anterior translation of the tibia on the femur with a diminished or absent end-point and may be indicative of an anterior cruciate ligament injury.

Patient in supine with knee flexed 90 deg. and hip flexed 45 deg. Therapist stabilizes lower leg by sitting on foot. Therapist grasps proximal tibia with hands and places thumbs on tibial plateau and administers a posterior directed force to tibia on femur. Positive test is indicated by excess posterior translation of tibia on femur with diminished/absent endpoint and may be indicative of PCL injury

Patient in supine with knee flexed to 20-30 deg. Therapist stabilizes distal femur with one hand and places other hand on proximal tibia. Therapist applies anterior directed force to tibia on femur. Positive test indicated by excess anterior translation of tibia on femur with diminished/absent end-point, may be indicative of ACL injury

Patient in supine with hip flexed and abducted to 30 deg. with slight medial rotation. Therapist grasps leg with one hand and places other hand over lateral surface of prox. tibia. Therapist medially rotates tibia and applies valgus force to knee while knee slowly flexed. Positive test indicated by palpable shift/clunk occurring between 20-40 deg. flexion and is indicative of anterolateral rotary instability. The shift/clunk results from reduction of tibia on femur

Patient in supine with knee flexed to 90 deg. and hip flexed 45 deg. Positive test indicated by tibia sagging back on femur and may be indicative of PCL injury.

Patient supine with knee flexed 90 deg. and hip flexed 45 deg. Therapist rotates foot 30 deg. medially to test anterolateral instability or 15 deg. laterally to test anteromedial instability. Therapist stabilizes leg by sitting on foot. Therapist grasps the prox. tibia with hands and places thumb on tibial plateau and administers an anterior directed force to tibia on femur. Positive test is indicated by movement of tibia occurring primarily on lateral side, may be indicative of anterolateral instability.

Patient in supine with knee flexed to 20-30 deg. Therapist positions one hand on medial surface of ankle and other hand on lateral surface of knee. Therapist applies valgus force to the knee with distal hand. Positive test indicated by excess valgus movement and may be indicative of MCL sprain. A positive test with knee in full extension may be indicative of damage to MCL, PCL, posterior oblique ligament, posteromedial capsule

Patient in supine with knee flexed 20-30 deg. Therapist positions one hand on lateral surface of ankle and other hand on medial surface of knee. Therapist applies varus force to knee with distal hand. Positive test is indicated by excess varus movement and may be indicative of LCL sprain. Positive test with knee in full extension may be indicative of damage to LCL, PCL, arcuate complex, poterolateral capsule

Patient in prone with knee flexed 90 deg. Therapist stabilizes femur using one hand and places other hand on heel. Therapist medially and laterally rotates tibia while applying compressive force through tibia. Positive test indicated by pain or clicking and may be indicative of meniscal lesion

Patient in supine. Therapist grasps heel and maximally flexes knee. Patient's knee extended passively. Positive test indicated by incomplete extension or a rubbery end-feel and may be indicative of meniscal lesion

Patient supine. Therapist grasps distal leg with one hand and palpates knee joint line with other. With knee fully flexed therapist medially rotates tibia and extends knee. Repeat same while laterally rotating tibia. Positive test indicated by click/pronounced crepitus over joint line, may be indicative of posterior meniscal lesion

1. Brush test: The patient is positioned in supine. The therapist 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. A positive test is indicated by a wave of luid just below the medial distal border o the patella and is indicative of effusion in the knee.

2. Patellar tap test: The patient is positioned in supine with the knee flexed or extended to a point of discomfort. The therapist applies a slight tap over the patella. A positive test is indicated if the patella appears to be floating and may be indicative of joint effusion.

1. Clarke's sign: The patient is positioned in supine with the knees extended. The therapist applies slight pressure with the web space of their hand over the superior pole of the patella. The therapist then asks the patient to contract the quadriceps muscle while maintaining pressure on the patella. A positive test is indicated by failure to complete the contraction without pain and may be indicative of patellofemoral dysfunction.

The patient is positioned in supine. The therapist flexes the knee and medially rotates the tibia with one hand while the other hand attempts to move the patella medially and palpate the medial femoral condyle. The positive test is indicated by a popping sound over the medial plica while the knee is passively flexed and extended.

The patient is positioned in supine with the hip slightly flexed and the knee in 90 degrees of flexion. The therapist places the thumb of one hand over the lateral epicondyle of the femur and the other hand around the patient's ankle. The therapist maintains pressure over the lateral epicondyle while the patient is asked to slowly extend the knee. A positive test is indicated by pain over the lateral femoral epicondyle at approximately 30 degres of knee flexion and may be indicative of iliotibial band friction syndrome.

The patient is positioned in supine with the knees extended. The therapist places both thumbs on the medial border of the patella and applies a laterally directed force. A positive test is indicated by a look of apprehension or an attempt to contract the quadriceps in an effort to avoid subluxation and may be indicative of patella subluxation or dislocation. REFERENCE: 1. http://quizlet.com/345930/kneespecial-tests-flash-cards/