LCL Stress Test

Question 1

What does the LCL stress test diagnose?

Answer 1

Instability of the LCL
Different variations are used to determine the severity of the injury & possible involvement of a cruciate ligament injury.

Question 2

What is the rationale behind the LCL stress test?

Answer 2

By applying a varus force, you gap the lateral joint line and put the LCL under tension. Having the knee in full extension and slight flexion can be used to differentiate the degree of damage.

Question 3

LCL Stress test procedure

Answer 3

1) Explain & IC
2) Patient in long sitting with hip abducted, quads & hamstrings relaxed
3) Physio supports abducted leg holding it under the thigh above the medial joint line & on the lateral surface of calf/ankle
4) Physio applies varus force to gap the lateral joint line with leg 1) in full extension & 2) in 20-30 degrees flexion
5) Observe end feel and stability and compare to other leg

Question 4

What is a positive result of the LCL stress test?

Answer 4

Pain @ 20 degrees flexion, no laxity = mild LCL injury
Pain & some laxity @ 20 degrees flexion = moderate injury; decreased integrity but ligament still partially intact
Gross instability, visual gapping of joint line @ 20 degrees = LCL complete rupture
Any instability in full extension = LCL tear & cruciate ligament involvement

Question 5

What is a negative result of this test?

Answer 5

No pain or laxity in any position, findings are similar on both sides.

Question 6

Result: Pain @ 20 degrees flexion, no laxity
What does this mean?

Answer 6

mild LCL injury

Question 7

Result: Pain & some laxity @ 20 degrees flexion
What does this mean?

Answer 7

moderate injury; decreased integrity but ligament still partially intact

Question 8

Result: Gross instability, visual gapping of joint line @ 20 degrees

Answer 8

LCL full rupture

Question 9

Result: Any instability in full extension
What does this mean?

Answer 9

LCL tear & cruciate ligament involvement