Knee Special Tests

Question 1

List the special tests that test for one-plane anterior instability?

Answer 1

1. Lachman
2. Anterior draw
3. Active draw

Question 2

List the special tests for one-plane posterior instability tests.

Answer 2

1. Posterior Draw

2. Posterior Sag sign

Question 3

List the special tests for Anterolateral instability.

Answer 3

1. Slocum’s

2. Lateral Pivot Shift Maneuver (Test Of MacIntosh)

Question 4

What position should the foot be placed in when testing for anterolateral and anteromedial instability during the Slocum’s test?

Answer 4

30 degrees IR and 15 degrees ER

Question 5

Which special test tests for one-plane medial instability?

Answer 5

Valgus Stress Test

Question 6

Which special test test for one-plane lateral instability at the knee?

Answer 6

Varus Stress test

Question 7

List the special tests for Meniscal pathology.

Answer 7

1. McMurray
2. Apley’s
3. Thessaly’s (gold standard)
4. Bounce Home

Question 8

The Tibial torsion special test is assessing?

Answer 8

Assess the amount of internal/external tibial rotation

Question 9

The varus/valgus angle assesses?

Answer 9

Assess the angle between the femur and the tibia.

Question 10

Clinician measures the varus/valgus angle of a patient and the results are 15 degrees on RLE and 12 degrees on LLE. Interpret the results.

Answer 10

> 10 degrees = Valgus; thus patient has bilateral valgus

Question 11

A value of <5 degrees for the varus/valgus angle would indicate what?

Answer 11

Varus

Question 12

Normal values for the varus/valgus angle is what?

Answer 12

5-10 degrees

Question 13

During the valgus and varus stress test a positive test while the knee is extended would be mean?

Answer 13

More severe injury with several structures being injured

Question 14

During the lateral pivot shift maneuver, during 30-40 degrees what should occur if the test is positive?

Answer 14

The Tibia will “jog” backwards and the patient will indicate that this is what if feels like when their knee “gives away”

Question 15

Prior to performing lachman’s, what structure should be cleared to avoid a false positive?

Answer 15

The therapist should clear the PCL prior to performing any one-plane anterior instability tests

Question 16

List the structures that may be involved with a positive varus test while the knee is flexed.

Answer 16

1. LCL
2. Bicep Femoris
3. ITB
4. Capsule
5. Accurate-popliteus complex

Question 17

List the structures that may be involved with a positive valgus test with knee flexed.

Answer 17

1. MCL
2. Post oblique ligament
3. PCL
4. Capsule

Question 18

List the structures that may be involved with a positive Valgus Stress test when the knee is extended.

Answer 18

1. MCL, PCL, ACL
2. Capsule
3. Medial quadriceps
4. Semimembranosis

Question 19

List the structures that maybe involved with a positive Varus Stress test while the knee is extended.

Answer 19

1. LCL, capsule, ITB
2. Bicep femoris
3. Arcuate-popliteal complex
4. PCL/ACL
5. Lateral gastrocnemius

Question 20

Positive test during the Lachman special test is indicated by?

Answer 20

1. Mushy/soft end feel

2. Excessive tibial translations (>4mm)

Question 21

If a therapist determines a positive lachman’s test (>4mm anterior tibial translation), what structures may be involved?

Answer 21

1. ACL/PCL

2. Arcuate-popliteus complex

Question 22

What is the position of the patient during lachman special test?

Answer 22

Supine with knee flexed between 0-30 degrees

Question 23

A positive active drawer test is indicated by what?

Answer 23

> 6mm anterior tibial translation

If, <6mm anterior tibial translation indicates only ACL is torn

Question 24

What structures may be involved with a positive anterior drawer test.

Answer 24

1. ACL
2. PL +PM capsule
3. MCL (Deep fibers)
4. ITB
5. POL
6. Arcuate-popliteus complex

Question 25

List what structures are involved during a positive solcum’s test which indicates lateral instability of the knee.

Answer 25

1. ACL/LCL/ PCL 2. PL capsule 3. Arcuate-popliteus complete 4. ITB

Question 26

List what structures are involved during a positive solcum’s test which indicates anteromedial instability of the knee.

Answer 26

1. ACL/MCL 2. POL 3. PM capsule

Question 27

What is the starting position of the patient during MacIntosh Test?

Answer 27

Patient is supine while test leg is flexed and abducted 30 degrees and relaxed in slight IR (20 degrees).

Question 28

What is the starting testing position of the patient for Posterior Sag sign (gravity draw test)?

Answer 28

Patient lies supine with the hip flexed to 45 degrees and the knee flexed to 90 degrees

Question 29

If a Posterior sag sign is positive, what structures may be involved?

Answer 29

1. PCL/ACL 2. POL 3. Arcuate-popliteal complex

Question 30

A therapist is performing a valgus stress test on a patient; in which direction should the therapist be applying for to stress MCL and medial structures?

Answer 30

Therapist should apply a MEDIALLY directed force at the Knee with ankle in slight ER.

Question 31

In what positions should the valgus/varus stress test be performed in.

Answer 31

1. Supine with knee flexed 20-30 degrees | 2. Supine with knee fully extended (positive in this position is more severe)

Question 32

A therapist is performing McMurray’s test on a patient. The therapist passively internally rotates the tibia while extending the knee with a varus force. The therapist is test which meniscus?

Answer 32

Lateral meniscus

Question 33

A therapist is performing McMurray’s test on a patient. The therapist passively externally rotates the tibia while extending the knee with a valgus force. The therapist is test which meniscus?

Answer 33

Medial meniscus

Question 34

A therapist is wanting to assess the angle of the femur and tibia (varus/valgus angle), where should the therapist measure to assess this angle.

Answer 34

1. ASIS to the mid-point of the patella 2. Mid-point of patella down the tibial shaft with goniometer (Stable arm: pointed toward ASIS; AOR: Midpoint of patella, Moving arm: Tibial shaft)

Question 35

A therapist is wanting to assess whether the patient is presenting with patellofemoral instability. What test should the therapist use?

Answer 35

Patellar apprehension test (knee flexed to 30 degrees, quads relaxed, therapists glides patella laterally)

Question 36

Explain the 5 point scale used in conjunction with the Brush (Stroke) test for the knee.

Answer 36

0 = no wave produced on down stroke 1 (trace) = small wave 1+ = larger bulge 2+ = spontaneous return after upstroke 3+ = unable to move effusion out of medial knee

Question 37

When is a pivot-shift positive?

Answer 37

(+) if tibia relocates during the test; as the knee is flexed, the tibia clunks backward at approximately 30-40 degrees