Knee
LCL & MCL
Evidence: suggestive
Apley’s Distraction Test Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Distinguishing ligamentous injury from meniscal injury.
How to Perform
- Position: Patient prone, knee flexed 90°.
- Action: Stabilize the thigh with your knee. Pull the tibia upwards (distraction) and rotate internally/externally.
Interpretation of Results
- Positive Test: Pain during distraction points to Ligament injury (unloading the meniscus).
Clinical Context & Limitations
The Apley’s Distraction Test 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 Apley’s Distraction Test with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment.
