Knee exam

1. Observation

• Ecchymosis (bruise)? Surgical scars?
• Knee resting position
• Knee effusion with obscured landmarks
• Quadriceps muscle atrophy

2. Knee effusion tests

• patellar ballotment
• knee milking

3. Range of motion

• Normal flexion = 130 degrees
  • look for pain
  • do active vs passive ROM
• Normal extension = 10 degrees above horizontal

4. Anterior Cruciate Ligament (ACL) Stability Tests

• Lachman's Test (most sensitive)
• Anterior drawer sign

5. Posterior Cruciate Ligament (PCL) Tests

• Posterior drawer test
• PCL sag test

6. Collateral ligament evalutation

• Knee valgus stress test (Medial collateral ligament)
• Knee varus stress test (Lateral colalteral ligament)

7. Meniscus Evaluation

• McMurrays Test (external rotation and extension from full knee flexion for medial meniscal tear, internal rotation and extension for lateral mensicusus)
• Apley's compression test (grind home test)

8. Standing evaluation

• Balanced weight on each leg
• Genu varum or venu valgum deformity
• Gait analysis
• Hip, knee and ankle alignment