Anterior Drawer Test Grading

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Diagnostic evaluation of the knee.

Anterior drawer test grading. This test is done by bending the hip 45 degrees and the knee 90. Lachman s test anterior drawer test pivot shift test clinical exam was performed by sports medicine fellowship trained orthopaedic surgeons. Based off the anatomical orientation placing the ankle into 10 15 degrees of plantar flexion puts a stress on the ligament which is enhanced when a posterior to anterior translation is applied. Anterior drawer has sensitivity of 86 percent and specificity of 74 percent for a diagnostic test of 160 patients with an inversion ankle sprain when compared to an arthrogram.

Increasing pressure to reduce health care expenses leads to investigate new methods to increase the precision of clinical tests which could be achieved through various reviews evaluating the diagnostic accuracy of these tests 10. Kocabey arthroscopy 2004 this study was a systematic review of orthopaedic tests for the knee no meta analysis performed. Patient supine with knee bent 90 examiner stabilizes foot with hip and places thumbs over the anterior knee joint line and pulls the tibia anteriorly. Springer science business media.

When your doctor examines the knee they inspect the joint test ligaments and mobility determine if there is swelling and perform specific manipulations to detect abnormalities. When the anterior drawer test is done if an audible snap or palpable jerk finochietto jumping sign occurs when the tibia is pulled forward and the tibia moves forward excessively a meniscal lesion is likely in addition to the torn anterior cruciate ligament. Ref strobel m stedtfeld hw. Because there is a subjective grading scale 0 3 for laxity it is important for the novice clinician to critically assess the motion and patient s response during the test.

Anterior drawer test is a clinical assessment of the knee to determine if there is an anterior cruciate ligaments acl injury. The function of the atfl is to resist anterior translation of the ankle and prevent internal rotation of the talus on the tibia. The posterior drawer test is part of a normal knee exam. The drawer test is used in the initial clinical assessment of suspected rupture of the cruciate ligaments in the knee.

The posterior drawer test is the mainstay test for assessment of a pcl tear. In the test one isolates the function of the pcl at 80 90 of knee flexion and applies a posterior translation stress to the knee. However it has been determined to be relatively inaccurate for objective testing for preoperative and postoperative assessment and should be augmented with the use of pcl stress xrays. The patient should be supine with the hips flexed to 45 degrees the knees flexed to 90 degrees and the feet flat on table.

2 in a prospective blinded diagnostic accuracy study croy et al.

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