Question

A football player had a twist of the knee and ankle, clinically no bony injury was appreciated. The examiner is doing the test as shown here. Which test is this?

• A. Ant drawer for ACL
• B. Post drawer for PCL
• C. McMurray
• D. Lachman

Hint:

The Lachman test is one of the most sensitive and specific tests for detecting ACL tears, especially in the acute phase.

Answer 1

The Correct Option is D

The given scenario describes a situation where a football player experienced a knee and ankle twist without any apparent bone injury. The examiner is conducting a specific test to assess the condition of the player's knee ligaments.

Lachman Test Explanation:

The Lachman test is commonly used to evaluate the integrity of the anterior cruciate ligament (ACL) of the knee. This test is considered more sensitive than the anterior drawer test for diagnosing ACL injuries.

Steps to Perform the Lachman Test:

• Positioning: The patient lies in a supine position (lying on the back) on the examination table, with their knee flexed to about 20–30 degrees.
• Stabilization: The examiner stabilizes the femur (thigh bone) with one hand to prevent movement.
• Movement: With the other hand, the examiner grasps the tibia (shinbone) just below the knee joint and pulls it anteriorly (towards them) while the femur is held steady.
• Assessment: The examiner assesses the amount of anterior movement (translation) of the tibia relative to the femur and the end feel (softness or firmness) to determine the presence of an ACL injury.

The increased anterior translation of the tibia compared to the uninjured knee, accompanied by a soft or mushy end feel, indicates a potential ACL tear.

Thus, the test described—where the knee is assessed without noticing a bony injury—is indeed the Lachman test, utilized to examine the integrity of the ACL following a traumatic event to the knee.