Ortho

7/19/99

 

McMurray

• Meniscal test
• Posterior is compressed on flexion
• 90° of flexion
• Palpate into the eyes of the knee
• Bring into extension
• Internal rotation aggravates lateral
• External rotation aggravates medial
• Positive sign is noise from the knee—clicking and snapping

Bounce Home

• Joint locking or giving away
• Flex knee and hip
• Support knee
• Dr. slowly extends knee
• Usually locks in extension
• Meniscal tear prevents locking of the knee

Steinman's Tenderness Displacement test

• Pain will follow tibia if Meniscal
• Anterior when extended and posterior on flexion

Apley's Compression Test

• Prone
• Knee flexed to 90°
• Drive tibia to posterior condyle
• External rotation is medial
• Internal rotation is lateral

Apley's Distraction

• Integrity of collaterals
• Prone
• Flex knee to 90°
• Pull on ankle
• Rotate

Abduction (valgus) and Adduction (varus)

• Leg fully extended has very little movement
• At 20° of flexion—a little more movement
• Push medially and laterally
• Do not hands directly over the knee joint
• Testing for lateral or medial collateral, PCL, ACL or capsule

Drawer's Sign

• Knee bent to 90°
• Stablize foot
• ACL—anterior translation of tibia
• PCL—posterior translation of tibia—on eyes of the knee push posterior

Lachman's test

• Knee to 30° flexion
• Bimanual force on the knee
• Stabilze the quads
• Reverse for posterior

Q angle—ASIS to mid patella—normal is 13°-18° valgus—test w/goniometer

Patellar Ballottement test

• Extended knee
• Tap patella
• Not much movement
• A lot of swelling, patella will seem like floating, pop back up

Bouchet's—patellar grinding test

• Compress patella and shift back and forth
• Crepitus from posterior patella

Clark's

• Web above superior patella
• Contract quads
• DJD or osteochondronins desecans
• Production of pain

Patella Apprehension Test

• Lateral deviation of the patella
• Look at face and quads

Dreyer's Test

• Flex hip—patella stabilizes the distal quad