Knee
ACL & PCL
Evidence: suggestive
Anterior Drawer Test (Knee) Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Assessing the Anterior Cruciate Ligament (ACL) (anteromedial bundle).
How to Perform
- Position: Patient lies supine with hip flexed 45° and knee flexed 90°.
- Action: Examiner sits on the patient's foot to stabilize it. Grasp the tibia behind the calf with thumbs on the tibial tuberosity.
- Force: Pull the tibia anteriorly.
Interpretation of Results
- Positive Test: >6mm of anterior displacement or a soft end-feel.
- Note: Often false-negative in acute injuries due to hamstring spasm or hemarthrosis.
Diagnostic Accuracy
- Sensitivity: 62% (Acute), 92% (Chronic)
- Specificity: 67-91%
Clinical Context & Limitations
The Anterior Drawer Test (Knee) should be considered as one component of a comprehensive musculoskeletal assessment. No single special test has perfect diagnostic accuracy; thus, clinical decision-making should integrate test results with patient-reported symptoms, mechanism of injury, functional impairment, and relevant imaging.
Clinicians should be aware of potential false-positive results in patients with pain sensitisation, muscle guarding, or poor relaxation. For the Knee region, combining the Anterior Drawer Test (Knee) with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment.
