Knee examination
Assessment of anterior cruciate ligament

The anterior drawer and Lachman tests can be used to access the integrity of the anterior cruciate ligament. In the anterior drawer test, the person being examined should lie down on their back (supine position) with the knee in 90 degrees flexion. The foot is secured on the bed with the examiner sitting on the foot. The tibia is then pulled forward by using both hands. If the anterior movement of the affected knee is greater than the unaffected knee, then the anterior drawer test is positive. The Lachman test is more sensitive than the anterior drawer test. For the Lachman test, the person lies down in supine position with the knee flexed at 20 degrees and the heel touching the bed. The tibia is then pulled forward. If there is 6 to 8 millimeters of laxity, with no definitive resistance when the knee is pulled, then the test is positive thus raising concern for a torn anterior cruciate ligament. A large collection of blood in the knee can be associated with bony fractures and cruciate ligament tear.
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