Knee
ACL & PCL
Evidence: confirmed
Losee Test Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Diagnosing Anterolateral Rotatory Instability (ALRI).
- Considered a dynamic variation of the Pivot Shift.
How to Perform
- Position: Patient supine.
- Action: Apply a Valgus stress and push forward on the fibular head (anterior force) while extending the knee from flexion.
Interpretation of Results
- Positive Test: A palpable 'clunk' is felt near full extension as the lateral tibial plateau subluxes anteriorly.
Clinical Context & Limitations
The Losee 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 Losee Test with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment.
