Posterior Drawer Test (Knee)

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Purpose
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To test the integrity of the posterior cruciate ligament (PCL)

Technique
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The patient is supine and the knee to be tested is flexed to approximately 90 degrees. The examiner then sits on the toes of the tested extremity to help stabilize it. The examiner grasps the proximal lower leg, approximately at the tibial plateau or joint line, and attempts to translate the lower leg posteriorly. The test is considered positive if there is a lack of end feel or excessive posterior translation [1]

[2]

Evidence
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Sensitivity and specificity have been reported as .90 and .99 respectively, while -LR is .10 and +LR is 90.[3]  Malanga et al concluded that the posterior drawer test was both very sensitive and specific, but is also enhanced by the presence of a posterior sag sign.[4]  Budoff and Nirschl agree that the posterior drawer is the best test to determine PCL integrity, but conclude that grading is the most important as this will determine the course of treatment.[5]

Resources[edit | edit source]

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Recent Related Research (from Pubmed)[edit | edit source]

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References[edit | edit source]

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  1. ↑ Flynn TW, Cleland JA, Whitman JM. Users' guide to the musculoskeletal examination: fundamentals for the evidence-based clinician. United States; Evidence in motion: 2008.
  2. ↑ Clinically Relevant Technologies, http://www.youtube.com/watch?v=mRyEvBrrl1k, Accessed May 2011
  3. ↑ Flynn TW, Cleland JA, Whitman JM. Users' guide to the musculoskeletal examination: fundamentals for the evidence-based clinician. United States; Evidence in Motion: 2008.
  4. ↑ Malanga GA, Andrus S, Nadler SF, McLean J. Physical examination of the knee: a review of the original test description and scientific validity of common orthopedic tests. Arch Phys Med Rehabil. 2003;84:592-603.
  5. ↑ Budoff JE, Nirschl RP. Knee problems: diagnostic tests for ligament injuries. Consultant. 1997;919-930.


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