Anterior Drawer Test of the Knee

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Video[edit | edit source]

[1]

Purpose
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To diagnose ruptures of the anterior cruciate liagment (ACL) by testing it's integrity ([2]).

Technique
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The patient lies supine on a plinth with their hips flexed to 45degrees, thier knees flexed to 90degress and their feet flat on the plinth. The physiotherapist sits on the patients foot (the side to be examined) and with both hands grasps the patients' proximal tibia (just below the tibiofemoral joint line) and pulls it forwards. If the tibia translates forward significantly more than the contralateral side, the test is considered positivie ([1]).

Evidence[edit | edit source]

[2] reported that the knee anterior draw test has a diagnostic accuracy of acute ACL ruptures (within 2 weeks of examination) of: 22.2% sensitivity and >95% specificity. The study reported the diagnostic accuracy of subacute/chronic ACL ruptures (more than 2 weeks before examination) is: 40.9% sensitivity and 98.4% specificity. It is important to note that in this study all examinations were performed under anesthesia; thus the diagnostic accuracy in physiotherapy clinical pracitice may be less. The knee anterior draw test, although widely used, is a poor diagnostic indicator of ACL ruptures, especially in the acute setting ([2]).

Both the Lachman test and the pivot shift test have been reported to have a greater diagnostic accuracy of ACL ruptures ([2]).

PubMed Feed[edit | edit source]


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References[edit | edit source]

  1. ↑ 1.0 1.1 bigesor. Anterior drawer test - knee. Available from: http://www.youtube.com/watch?v=yQdBrr3Mmj0 [last accessed 18/8/13]
  2. ↑ 2.0 2.1 2.2 2.3 Katz JW, Fingeroth RJ. The diagnostic accuracy of ruptures of the anterior cruciate ligament comparing the Lachman test, the anterior drawer sign, and the pivot shift test in acute and chronic knee injuries. The American Journal of Sports Medicine 1986;14:88-91.fckLRhttp://ajs.sagepub.com/content/14/1/88.short (accessed 18 July 2013).
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