Comprehensive Clinical Examination of ACL Injuries

David E Kantrowitz; Alexis Colvin

doi:10.1016/j.csm.2023.08.001

Comprehensive Clinical Examination of ACL Injuries

Clin Sports Med. 2024 Jul;43(3):311-330. doi: 10.1016/j.csm.2023.08.001. Epub 2023 Sep 14.

Authors

David E Kantrowitz¹, Alexis Colvin²

Affiliations

¹ Department of Orthopedics, The Mount Sinai Hospital, 5 E 98th Street, 9th floor, New York, NY 10029, USA. Electronic address: [email protected].
² Department of Orthopedics, The Mount Sinai Hospital, 5 E 98th Street, 9th floor, New York, NY 10029, USA.

PMID: 38811112
DOI: 10.1016/j.csm.2023.08.001

Abstract

A comprehensive clinical examination of the potentially anterior cruciate ligament (ACL)-deficient knee should proceed as follows: inspection; palpation; range of motion; varus and valgus stress; neurovascular status; and finally provocative maneuvers. The Lachman, anterior drawer, Lever, and pivot shift tests are all greater than 90% specific for ACL pathology. Due to the relatively high coincidence of ACL injuries and those to the posterior cruciate ligament, posterolateral corner , posteromedial corner , and menisci, it is critical that the examiner perform provocative maneuvers to evaluate the integrity of these structures as well.

Keywords: ACL; Anterolateral instability; Knee exam; Lachman; Pivot-shift.

MeSH terms

Anterior Cruciate Ligament
Anterior Cruciate Ligament Injuries* / diagnosis
Humans
Knee Injuries / diagnosis
Physical Examination* / methods
Range of Motion, Articular