The Lachman Test

Presentation and Examination: The knee anterior drawer test is a commonly used during orthopedic examinations to evaluate the integrity of the anterior cruciate ligament (ACL). The test is conducted with the patient supine; hips and knees are flexed at a 45 and 90-degree angles with feet flat on the table. While holding the calf distal to the knee joint pulling suddenly away from the patient tests the anterior drawer while pushing back tests the posterior drawer. In this case, the positive anterior drawer test indicated ACL damage.

The ACL is one of the most frequently uinjured ligaments of the knee.( 59 )

The purpose of this article is to compare the laxity and stiffness of the knee joint in male and female cadavers. Three different directions will be evaluated, anterior-posterior, internal-external, and varus-valgus. Females are at a two to eight times greater risk of an ACL injury than a male. This is due to the laxity in the joints. Females also have limited proprioception in the knee joint, which may attribute to some injuries. This study used a technique using cadaver knees to complete this study.

In addition, regression analysis was used to determine independent variable among age, BMI, grip strength, sex and K/L grade for knee pain. The result indicated that the most significant variable was BMI correlated with the occurrence of knee pain. ORs of BMI (+5 kg/m2) was 1.54 and the risk was 0.60 which was significant. This implied that the ORs of K/L grade for knee pain can be overestimated due to the possibility of extremely low risk of K/L grade. In fact, the percentage of participants who suffered from knee pain with K/L (grade 2) and K/L (grade 3 and 4) was just 61.0% and 71.0% respectively. In other words, it will be about 40% of participants with K/L grade 2 and about a third of subjects with K/L grade 3 and 4 had no pain at the knee joint at follow-up.

An anterior cruciate ligament tear can be confirmed by the Lachman test, the dynamic extension test, and the Pivot jerk test. The Lachman test and dynamic extension test is helpful in, “making a diagnosis, particularly in the acute injury.” (1) The lateral pivot test reproduces, “the rotatory subluxation that occurs in ACL defiency. The test is difficult to perform and takes residents and fellows in my practice approximately three months of intensive training to be able to adequately perform the jerk test in the unanaesthetised patient.”(1) The test is important because the demonstration of the lateral pivot jerk is the replication of the instability that the patient has. The initial goals of treatment immediately after injury are to reduce pain, reduce

This study hypothesizes that knee joint auscultation during Lachman test is capable of judging Anterior Cruciate Ligament on the basis of objective data. Particularly, frequency of Lachman sound is able to access ACL condition.MethodologyThis study was conducted in accordance to the protocol proved by the Institutional Review Board, which entailed two separate phases. First phase involved 30males and 30 females,healthy volunteers while the second phase involved 24 patients who went through ACL reconstruction.The Lachman test was performed by one orthopaedic surgeon

For shoulder flexion 61% of the variance could be accounted for by the sit-and-reach. A correlation was also found between the modified sit-and-reach test and both the shoulder extension and hip flexion tests. For shoulder extension 33% of the variance was accounted for by the modified sit-and-reach and for hip flexion 22% of the variance was accounted for by the modified sit-and-reach.

A clinician, respectively, should produce the patient’s clinical history and results, as well as the measurement properties of the index, this well better format and put in place short- and long-term goals based on an individual-report functional scale like the LEFS (1). The intention of this research was to assess the reliability, construct validity, and sensitivity to change the Lower Extremity Functional Scale. This test was given to 107 patients with lower-extremity musculoskeletal dysfunction referred to twelve outpatient PT clinics. This index was dispensed during the patient’s initial assessment, 24 to 48 hours following the initial assessment, and then at weekly intervals for four weeks (1). A patient with an initial LEFS score of 56/80, an example of lower extremity functional scale is to create functional level, set goals, and track progress and outcome, based on the error at any specific position in time for the LEFS of five points, the therapist can be highly confident that the actual scale score is between 51 and 61 (1). The leeway, or error, associated with an assumed measure on the LEFS is about plus or minus five scale points (90% confident intervals). A clinician, ergo, can be moderately confident that an observed score within the parameter of five points of the patient’s “true” outcome (1). The short-form 36-health survey (SF-36) is a 36-item, patient-delivered

The test has the physician move the patellar back and forth while the patient flexes the knee at 30 degrees (Saladin, 1998, p. 44). This test helps diagnose how severe the patella is dislocated and decide the best treatment option. Another test a physician can do is called the patella tracking assessment where they have the patient single leg squat and then stand (Slamaian). If the “patella that slips medially on early flexion is called the J sign, and indicates imbalance between the VMO and lateral structures” (Saladin, 1998, p. 41). Both of these test help diagnose the correct treatment, the difference is the patellar apprehension test is used for more severe cases but both lead to the best treatment

This study included 28 patients who underwent ACL surgery performed by the same 2 surgeons and standard rehab protocol was done in the same physical therapy clinic, with all the same exercises and progressions. The Battery Test uses exercise analysis to grade the participants. The exercises include measurement of isokinetic strength, single hop for distance, triple hop, side hop, and a jump-landing assessment. There were also patient surveys that asses their feelings about the overall health of their knee. The participants completed this testing 6 months after surgery, which is the average RTP time frame for basic ACL rehab protocol. Out of all 28 patients, only 2 individuals passed this test and can be considered safe for RTP. This information is extremely important for anyone who has the authority to grant RTP to any athlete. Allowing patients back to play too soon is extremely dangerous and can cause further injury. Using this specific test to determine RTP decisions is a great technique to utilize in athletic

The Anterior Cruciate Ligament also known as the ACL is deemed the most commonly torn ligament in the knee and can result from both contact and noncontact injuries. Most Anterior Cruciate Ligament injuries result from an extreme force on the lateral side of the person’s knee causing a valgus force which pushes the knee inward (Kisner & Colby, 2012, pp. 802-803). This injury to the side of the knee can also cause a “Terrible Triad” injury which also injures both the medial meniscus and the medial collateral ligament (Kisner & Colby, 2012, p. 803). Our textbook further states that “the most common noncontact mechanism is a rotational mechanism in which the tibia is externally rotated on the planted foot….this mechanism can account for as many as 78% of all ACL injuries” (Kisner & Colby, 2012, p. 803). If the person does not seek medical help with this injury they are susceptible to also injuring the remaining support ligaments as well. Patients usually present with joint effusion; possibly 25 degrees of flexion, joint swelling if blood vessels are involved, limited ROM, stress pain and instability along with quads avoidance gait patterns (Kisner & Colby, 2011, p. 208)

A torn ACL is one of the most serious and common knee injuries. Many aspects play a role in the treatment and rehabilitation of this injury. This paper will discuss the anatomy of the knee, describe a torn ACL, and the rehabilitation.

When the patient completes the rehabilitation period, for understanding how much was it successful to achieve the normal level of functional stability, balance, and coordination with minimal risk of re-injury, the patient must be doing some functional testing before starting cleared for full activity. The physiotherapist can use the screening test to determine which patient have a high risk of ACL

This year, I was selected as the September Student of the Month for Logan Elm High School. I then attended the Rotary luncheon, and was given a keychain that contained the Four-Way-Test on it. After the meal, I began to consider how I have applied the characteristics and questions listed on the keychain in all of my situations. The Four-Way Test serves as the foundation for ethics and making effective decisions. This test should be taught at a young age, encouraging youth to understand the effects of their choices.

This instrument has a high validity and reliability to control pain and swelling with used with elevation. Appendix 4 has the Lower Extremity Functional Scale (LEFS) will be used to get the patient’s perspective on their rehabilitation. This scale will be used to evaluate the patient’s thoughts on their limitations. It will also be used to track the progress from their perspective. The questionnaire includes 20 questions that relate to everyday tasks. This instrument has a Standard Error of Measurement (SEM) of 3.7 points in reference to ACL Reconstruction (Weinhold, et al., 1999). The MMT grading scale will be used to look at the strength of the knee in the study (Appendix