What is anterior drawer test?
Anterior drawer test perform by orthopedic doctor to know any inflammation in anterior cruciate ligament (ACL). There are some other test is perform to conform injury in ACL. This test is very easiest to perform and take less time as compare to other test.
Doctor is easily identified sprain or tear of ACL by the help of this test.
What is ACL?
ACL (anterior cruciate ligament) is the most important part of our knee. In the knee is composed with four different thing bone, cartilage, ligament and tendons. cruciate ligament helps to bind these four element every side. Front side name as anterior cruciate ligament, back side posterior cruciate ligament. Same lateral cruciate ligament and the collateral cruciate ligament in both side.
Cruciate ligament helps to back side movement of leg.
What type of people are mostly affected ACL injury?
Common people are not affected by ACL injury. Mainly Athletes are affected by ACL injury who are played cricket, football and basketball like game.
Some people affected by ACL injury in severe accident.
How to perform anterior drawer test for knee?
Doctor is perform this test and this test is take five minutes.
First sleep the patient in test table.
To perform the anterior drawer test take patient’s hip to 45 degree and your patients knee to 90 degrees of flexion.
You can fixate this position by gently sitting on the foot of your patient.
Then palpate the joint line with your thumbs, and try to move the tibia anteriorly in an explosive movement.
This test is positive if the tibia translates anteriorly more than six millimeters or if you experience a soft and mushy end feel.
Similar test to Know the injury of knee
Posterior Drawer Test
this test is similar to anterior drawer test and this test is also perform by the Doctor. In this test doctor check the injury of posterior crucial ligament.
Told the patient to sleep supine position in test table.
And ask the to flex the hip to 45 degree and knee to 90 degree. Doctor lightly sit foot of the patient then hold the joint of knee.
At this situation push the tibia serially in explosive movement.
This test is positive if tibia translate posteriorly more than 6 millimeter or you feel soft in joint.
Lachman test is other wise know as Richie trailer test. This test is more valid for ACL injury. Doctor recommend check PCL injury before ACL Injury because tibia translate posteriorly regarding fumor.
Ask the patient to sleep in test table supine position. And take the patient knee in 30 degree and hold the patient femur in outer hand. Try to translate tibia anteriorly with the help of inner hand.
The test result is positive if translation is more than 3 millimeter.
Lateral Pivot-Shift Test
To perform the pivot shift test have your patient in supine line position with us hip both flexed and abducted to 30 degrees.
Then grab your patient’s calcaneus from the outside to induce tibial internal rotation. Some authors also describe added axial compression.
Now with the other hand you want to give a slight Valgus force from the outside at the height of the fibula which subluxes the TBR anteriorly from the femur in extension in case of a torn ACL.
Then move your patients leg from extension to flexion.
This test is positive if the tibia reduces or jogs backward at around 30 to 40 degrees of knee flexion due to the tightening of the iliotibial band. Often this also produces a clunk sound and the patient describes the feeling as the giving way feeling that he knows from walking.
The McMurray Test is doing by the doctor to identified any meniscal damage.
To Perform this test, have your patient in supine laying position, with the tested knee fully flexed. Then, rotate the tibia medially and bring the knee into extension.
Doctor would want to repeat this process a couple of times with a different angle of knee flexion, in order to test the whole posterior aspect of the lateral meniscus.
In order to test the medial meniscus, bring the knee into full flexion and laterally rotate the tibia. The anterior half of the meniscus is not as easily tested with the McMurray Test, because the pressure on the meniscus is not as high.
This test is considered positive if your patient experiences clicking, locking or pain in the knee.
x-rays, CT scans,and MRIsall are comes under imaging test. But there are some different in imaging test. Many conditions do not require imaging tests for us to make a diagnosis.
There will be a time though that your doctor might find it appropriate to order an imaging test to make a thorough diagnosis and give you the best treatment possible. Radiographs are very good at showing broken bones or dislocated joints. Radiographs use x-rays to take pictures.
A CT or computed tomography scan also uses x-ray beams to give more detailed images of the inside of your body, but itexposes you to more radiation than an x-ray.
With a CT scan, you lie down on a table and pass through a tunnel-like device.
For an MRI. or magnetic resonance imaging, you also must lie still and go through a tunnel-like device. An MRI creates very detailed images of the inside of your body and does not useradiation. Your doctor will advise you if an imaging test is needed and which one is right for you.
Accuracy of the Test
According to American journal of sport and medicine all type of ACL injury test specificity is more than 90% where sensitivity many vary for person to person and age goup.
Anterior drawer test specificity is 95.2% and sensitive 40.9%.
Lachman test was 81.8% sensitive and 96.8% specific.
The pivot shift test has 81.8% sensitive and 98.4% specific.
What happen if anterior drawer test is positive?
The doctor doing the anterior drawer test to an identified ACL injury. When the test is positive then treatment started according to severity of injury.
If the patient are doing more active work then doctor advice to surgery to return to daily work. If the patient are less active or old age group people there are some chances of risk of surgery.
There are some non surgical treatment is also recommended by the doctor for those patient who are less active or elder age goup patient. Doctor attach to a brace to the knee and advice to take test.
Some time doctor advice some physical excise to given the strength in leg.
But most of the cases surgery is more effective than non surgery treatment.
ACL Injury ligament are fracture or broken. In surgery doctor replace ligament with a tissue graft. Tissue graft gradually turned in to ligament gradually.
Anterior drawer test is best psychical test for ACL Injury and doctor like to do other test to conform the ACL injury.
There are mostly three different stages of ACL injury. In this injury swelling of knee and pain occur during regular activity. If you feel this sign and symptoms then take the doctor advice for the treatment.
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