Download Knee Lab

Sports Medicine
Lab – Knee
Anatomical Identification
A. Bony Palpation – Be able to palpate these structures on your partners knee
1. Medial Aspect (173-175)
a. medial joint line
b. medial tibial plateau
c. tibial tubercle
d. medial condyle of the femur
e. medial epicondyle of the femur
2. Lateral Aspect (176-178)
a. lateral joint line
b. lateral tibial plateau
c. lateral condyle of the femur
d. lateral epicondyle of the femur
e. fibula head
B. Soft Tissue Palpation
1. Anterior Aspect (178-180)
a. supra patellar tendon
b. infra patellar tendon
2. Medial Aspect (180-182)
a. medial collateral ligament
b. medial retinaculum
c. pes anserine group (sartorius, gracilis, semitendonosus)
3. Lateral Aspect (182-183)
a. lateral collateral ligament
b. lateral retinaculum
4. Posterior Aspect (183-184)
a. biceps femoris tendon
b. popliteal fossa
C. Stress Tests
1. Valgus Test - Full extension
Have the athlete lying supine on a table. Grasp above the ankle joint with
one hand and place the heal of the opposite hand on the lateral joint line of
the knee and apply a valgus stress (medial). A positive test indicates a
rupture of the medial collateral ligament.
2. Valgus Test 20-30˚ flexion
Same position as above except knee is at 20-30˚ flexion. This allows you
to check both the superficial and deep layers of the medial collateral
ligament.
3. Varus Test – Full extension
Have the athlete lying supine on a table. Grasp above the ankle joint with
one hand and place the heal of the opposite hand at the medial joint line of
the knee and apply a varus stress (lateral). A positive test indicates a tear
of the lateral collateral ligament.
4. Varus Test 20-30˚
Same position as above except the knee is at 20-30˚ flexion. This allows
you to check both the superficial and deep layers of the lateral collateral
ligaments.
5. Anterior/Posterior Drawer Tests
Anterior Drawer - athlete lying supine on table with hips flexed to 45˚ and
knees flexed to 90˚ foot stabilized (examiner sits on foot). Grasp behind
the knee with both hands, place thumbs below joint line and pull
anteriorly. Positive test indicates a rupture of the anterior cruciate
ligament.
Posterior Drawer – same position as above for athlete and examiner and
push posteriorly. Positive test indicates rupture of the posterior cruciate
ligament.
6. Lachman Test
Athlete is lying supine and knees are extended. For the left knee, position
yourself on the left side of the athlete. Place your right hand above the
patella with the thumb on the anterior thigh. Left hand is on the tibia with
the thumb on the tibial tuberosity. Flex knee to 20˚ and pull tibia forward
on the femur while pushing femur posteriorly.
7. McMurray’s Test
Athlete is lying supine on the table with legs extended. Position yourself
on the outside of the right knee. For lateral meniscus grasp the knee with
the right hand with thumb over lateral joint line. Fully flex knee to chest
while laterally rotating tibia and apply a valgus stress and extend the knee.
For a medial meniscus medially rotate the tibia and apply a varus stress.
A “clicking or popping” sensation felt at the joint line is indicative of a
possible meniscal tear.
8. Apley Grind
With the athlete lying prone have the knee flexed to 90˚. Place one hand
with fingers on the joint line and the opposite hand on the foot. Apply a
downward pressure and rotate the tibia medially and laterally. A “pop or
snap” indicates a meniscal tear