Posterior Drawer Test (Knee)

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Purpose

The posterior drawer test evaluates the posterior cruciate ligament.

Technique

The patient laying supine with the knee in ninety degrees of flexion. The foot of the patient is stabilized on the table. The fysiotherapist grabs the anterior aspect of the tibia over the tibial tuberosity and push forward with a steady force. The tibia displaces posteriorly. If the posterior translation of the tibia is more than normal (compared with the healthy side), the test is positive. This is indicative of a posterior cruciate ligament tear. (1)

Evidence

Results from a blinded, randomized, controlled study shows that the accuracy for detection of a PCL-tear is 96%, with 90% sensitivity and a 99% specificity. For grade 2 and grade 3 posterior laxity, the examination accuracy was higher than for grade 1 posterior laxity. (2)

Resources

- http://www.aclmd.com/Publications/Abstracts%20pdf/PCL_Accuracy.pdf

References

(1) Magee DJ. Orthopedic Physical Assessment: 5th Edition. St. Louis, MO: Saunders Elsevier;2008.
(2) The Accuracy of the Clinical Examination in the Setting of Posterior Cruciate Ligament Injuries. Rubinstein RA Jr., Shelbourne KD, McCarroll JR, et al: Am J Sports Med 22: 550-557, 1994