Ligament or Tendon Origin
Navigate through this section using the buttons below. We have also included a global screen video which you can see below as well.
Below we have included a video of a global screen for the ligaments in the knee. First, we have listed the write-up of the information included in the video.
Global Screen for Ligaments (Dutton)
Godfrey Sign (PCL injury)
Patient position: Supine with knee flexed to about 90 degrees
Examiner: Observes for a posterior lag or a step off deformity of the tibia. If the examiner is unsure about the results, this test can be progressed in two ways: (1) Ask the patient to contract their hamstrings and dig their heals into the table (2) Elevate the lower extremities so that the hips are at 90 degrees and the knee position is maintained in 90 degrees
Positive test: Increased laxity and/or provocation of the patient’s pain; Excessive posterior translation of the tibia in relation to the femur
Lachman Test (ACL injury)
Patient position: Supine with knee in 30 degrees of flexion
Examiner: Check of ACL function through anterior translation of the tibia while stabilizing the proximal leg
Positive tests: Increased laxity and/or provocation of the patient’s pain: 5mm or less (mild), 10 mm or less (moderate), More than 10 mm (severe)
Valgus Stress Test (MCL injury)
Patient position: Supine with the knees extended
Examiner: Applies a valgus stress to the joint line with a counterforce on the lateral distal femur. The test should be done in two different degrees of motion: First, in full extension (0 degrees of flexion) in order to check the ligament in the most stable position first (If this part of the test is positive, DO NOT continue!) Second, in 30 degrees of flexion.
Positive findings : Increased laxity and/or provocation of the patient’s pain; Increased laxity at 0 degrees of flexion indicates a severe tear; Increased laxity at 30 degrees of flexion indicates a mild to moderate injury
Varus Stress Test (LCL injury)
Patient position: Supine with the knees extended
Examiner: Applies a varus stress to the joint line with a counterforce on the medial distal femur. The test should be done in two different degrees of motion: First, in full extension (0 degrees of flexion) in order to check the ligament in the most stable position first (If this part of the test is positive, DO NOT continue!) Second, in 30 degrees of flexion.
Positive findings: Increased laxity and/or provocation of the patient’s pain; Increased laxity at 0 degrees of flexion indicates a severe tear; Increased laxity at 30 degrees of flexion indicates a mild to moderate injury
Patient position: Supine with knee flexed to about 90 degrees
Examiner: Observes for a posterior lag or a step off deformity of the tibia. If the examiner is unsure about the results, this test can be progressed in two ways: (1) Ask the patient to contract their hamstrings and dig their heals into the table (2) Elevate the lower extremities so that the hips are at 90 degrees and the knee position is maintained in 90 degrees
Positive test: Increased laxity and/or provocation of the patient’s pain; Excessive posterior translation of the tibia in relation to the femur
Lachman Test (ACL injury)
Patient position: Supine with knee in 30 degrees of flexion
Examiner: Check of ACL function through anterior translation of the tibia while stabilizing the proximal leg
Positive tests: Increased laxity and/or provocation of the patient’s pain: 5mm or less (mild), 10 mm or less (moderate), More than 10 mm (severe)
Valgus Stress Test (MCL injury)
Patient position: Supine with the knees extended
Examiner: Applies a valgus stress to the joint line with a counterforce on the lateral distal femur. The test should be done in two different degrees of motion: First, in full extension (0 degrees of flexion) in order to check the ligament in the most stable position first (If this part of the test is positive, DO NOT continue!) Second, in 30 degrees of flexion.
Positive findings : Increased laxity and/or provocation of the patient’s pain; Increased laxity at 0 degrees of flexion indicates a severe tear; Increased laxity at 30 degrees of flexion indicates a mild to moderate injury
Varus Stress Test (LCL injury)
Patient position: Supine with the knees extended
Examiner: Applies a varus stress to the joint line with a counterforce on the medial distal femur. The test should be done in two different degrees of motion: First, in full extension (0 degrees of flexion) in order to check the ligament in the most stable position first (If this part of the test is positive, DO NOT continue!) Second, in 30 degrees of flexion.
Positive findings: Increased laxity and/or provocation of the patient’s pain; Increased laxity at 0 degrees of flexion indicates a severe tear; Increased laxity at 30 degrees of flexion indicates a mild to moderate injury
Not looking for something of ligament/tendon origin? Navigate to our other pages.
References:
- Dutton M. Orthopaedic Examination, Evaluation, and Intervention. 2nd ed: The McGraw-Hill Companies, Inc.; 2008.