Special tests for knee joint

SPECIAL  TESTS  FOR  KNEE  JOINT :-


SPECIAL TESTS  FOR  ACL INJURY:-

The  Anterior cruciate  ligament  provides anterior  stability  to knee joint . It's  main function  is to prevent anterior  movement   of  tibia on femur.

THE CAUS OF  ACL  TEAR  IS HYPEREXTENSION  INJURY AS IN  FOOTBALL  PLAYERS.

ŤESTS:- 1 ANTERIOR  DRAWER  TEST:-

• Patient lies  in supine lying  .
• The  hip joint  should  be  flexed  at 45° while  the knee joint   should  be  90° flexed.
• The  therapist  grasp  proximal  leg  just below  the  tibial plateu.
• The therapist  attempts to translate  lower leg  anteriorly .
• The  test will be positive  if there is excessive  movement of tibia as compare  to opposite  side.
  

2  LACHMAN   TEST  :-  

IT  is  best  test  indicator  of   ACL  injury  specially  for  posterior  band.

• The  patient  lies   supine  with knee  flexed  at   30°. 
• This is functional  position  of  knee  joint  in which  the ACL plays a majorange  role.
• The  examiner stabilises  the  patient 's   femur  with one  hand  while  the  other  hand  moves  the  tibial in forward  direction. 
• Positive  sign is  indicated  if   excessive  anterior  tibial translation  occurs  with medial  rotation of tibia.
  

SPECIAL  TESTS  FOR  PCL  INJURY :-

The   posterior  cruciate  ligament  is a strong  ,fan shaped  ligament  strongest  ligament  in knee  joint  .

It  stabilises   the  knee  against  posterior  movement  of  tibia  on femur. 

THE   LIGAMENT  COMMONLY   INJURED  DURING   DASHBOARD   INJURY.

TESTS:-     1  POSTERIOR   DRAWER  TEST:-
These  is  performed  from   posterior   cruciate  ligament  tear. 

• Patient  lies  in  supine  lying  with  hip in 45 °of  flexion  and  knee  should  be  flexed  90°.
• The  examiner  sits  on toes  of  patient to  stabilise  the  leg.
• The  examiner  grasps  the  lower  leg  just below  the  tibial  plateu. 
• The  examiner  gently  moves  the  tibial  in posterior  direction .
• Excessive  posterior  translation  of tibia  in comparison  to opposite  limb  shows PCL  INJURY.

MCL   INJURY  :- 

The  medial   collateral   ligament  provides  medial  stability to knee joint.

The  MCL  works against  the   valgus   force.

 IT  COMMONLY  INJURED  DUE  TO EXCESSIVE    VALGUS  FORCE.

TESTS:-  VALGUS  OR  ABDUCTORS  STRESULTS  TEST:-

• The  patient  lies  in supine  lying  first  with knee  extended .
• The  therapist  grasps  the  distal part of  leg around  hair  line  and slightly lifts the  leg from table.
• The  therapist place other hand  on lateral  side  of  knee joint  and applys  inward   force.
• Same  procedure the  therapist  perform sith slight knee flexion (20 to 30°).
•  If  tibia  moves  away  from femur  an excessive  amount  when valgus force  is  applied  shows  the  test is  positive.
  
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LCL   INJURY:-    

The    Lateral  collateral  ligament   provides  protection  to lateral  aspect  of  knee.

THE  LCL  LIGAMENT  COMMONLY  INJURED DUE  TO EXCESSIVE  VARUS  FORCE.

TEST:-   VARUS  OR ABDUCTOR  STRESS  TEST:-

It is  performed  for  identify  lateral instability  of  knee joint.

• The  patient  lies  in  supine  lying. 
• The therapist  stabilises  the  ankle and  slightly  lifts  le leg from table.
• The  therapist  applies  varus force  or pushes  knee  laterally. 
• The  test is done  first  with full knee  extension and  then with the  knee  20°to 30° flexion. 
• If  the  test is  positive  the tibia moves away  from  femur  when  varus force   is applied. 
  
• MENISCUS  TEAR  :-   

THE   FOLLOWING   TESTS  ARE PERFORMED :- 

1  MCMURREY  TEST  :-

Patient  lies  on  supine  lying  position with  hip knee flexion  .

• The  therapist  stabilises  the  knee  with one  hand and  grasp the  heel  of  patient  with other hand.
• Therapist  applies  inword pressure  through  heel  and  rotates  the  tibia medialy and lateral you. 
• Positive  test indicates  manicus  injury if  production of  pain  occurs.

OTHER  TESTS  FOR  MENISCUS   TEAR ARE:-

1. DUCK  WALKING TEST
2. DISCO  TEST 
3. APLEY 'S  TEST.