Flashcards in 04 Knee Special Tests: PCL Deck (23):
What are the clusters of s/s for PCL tests?
- hx macrotrauma
- hyperextension injury
- fall on anterior tibia with ankle in plantarflexion
- intra-articular effusion
- suspected ACL
example of a hyperextension injury
Why do the PCL tests if you suspect ACL?
do the tests for each together
For PCL tests, how much should the knee be flexed?
less than 90˚
Why must you flex the knee to less than 90˚ in PCL tests?
- meniscus will become wedged and block anterior motion
- patient will have effusion
What does the recurvatum test for PCL test?
- posterior capsule
PCL: recurvatum test procedure
- stabilize distal femur with one hand and grab ankle with other
- pull up on ankle 3x, hyperextending the knee
for the PCL recurvatum test, what is normal?
PCL: sag test procedure
- flex knee to 70-80˚
- look at knee from the side
What is a positive sag test?
- concavity from the inferior pole of patella to tibial tuberosity
- PCL is torn
What is happening to the tibia in a positive sag test?
tibia will sag posteriorly
Evidence for the Clancy step-up test
- no evidence
- Davies says this one gives him a good idea of where the tibia is sitting
Clancy step-up test position
- sit on foot to stabilize
- hands in SRP
- IP joints line up with joint line
- flex IP joints
What are you palpating in addition to the tibia for the Clancy Step-Up test?
- make sure they aren't contracting them
- seeing if there's spasm
What should you feel in the Clancy step-up test when you flex the thumbs?
should feel a 10 mm step up of the tibia toward you relative to the femur
What will you feel with a positive Clancy step-up test?
femur feels closer than 10 mm to the edge of the tibia
What does a positive Clancy step-up test mean?
means it's subluxated posteriorly
posterior drawer test: What is this for?
posterior drawer test procedure
- hands in same position as Clancy step-up
- SRP is neutral if tibia isn't sagged back
- straighten elbows, pushing tibia straight back
posterior drawer test: What would happen if there's a PCL tear?
tibia subluxates posteriorly
posterior drawer test: Which types of PCL tears are often missed and why?
- acute PCL tears
- people don't do the first 3 tests
1. tibia is already sagged back
2. won't move during the test
posterior drawer test: What are the types of PCL tears?