Knee Brace Composition - What Manual Tests Are Involved In Diagnosing An ACL Tear-

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					The Lachman Test

An examiner who is skilled can often times detect an injury in your knee before
ordering other tests like an MRI or an x-ray. One such manual test is the Lachman test.
Named after John Lachman, M.D., the Lachman test is performed to test a person's
ACL for stability. More specifically, the goal of this test is to help determine if the
ACL has been torn or if it is still intact.

To perform the Lachman test, the patient should be laying supine (on their back) with
their knee in approximately 20-30 degrees of flexion. The leg that is being tested
should also be externally rotated. The individual conducting the maneuver needs to
place one hand on the patient's thigh, while the other hand needs to be placed behind
the tibia, with one thumb placed on the tibial tuberosity. The examiner pulls anteriorly
on the tibia to determine forward translation of the tibia on the femur. (The tibia is the
larger of the two bones in the leg, while the femur is the thigh bone.) When pulling
anteriorly on the tibia, an intact ACL should prevent forward translation movement of
the tibia on the femur. This is known as a "firm endpoint". On the other hand, if the
end point is "soft", and the tibia can move forward on the femur, then this suggests
that the ACL is torn.

The Anterior Drawer Test

A second commonly used test, among several, to determine the stability of the ACL is
the Anterior Drawer Test. In this test, the patientis lying supine (on their back) with
their hips flexed to 45 degrees and their knee to 90 degrees. The individual
performing the test then grasps the tibia just below the knee, with their thumbs on
either side of the patellar tendon. It is important to note that the hamstring muscle
group must remain relaxed to help ensure a proper test. (The index fingers can be used,
by the examiner, to test the hamstrings). Once the examiner is in position, the tibia is
then drawn forward anteriorly. When the examiner notes that one side has increased
amount of anterior tibial translation compared to the opposite limb, this will help
indicate whether an ACL injury has occured.

If these tests are positive and the ACL is sprained, or can be torn. Depending on the
severity of the injury, a knee brace can help provide meaningful stability, and can help
reduce pain as well. These knee braces are widely used among sporting professionals
with previous ACL injuries, and can aid individuals to help get moving again with

Reference : Starkey, C., & Ryan, J. (2003). The Knee. Orthopedic & Athletic Injury
Evaluation Handbook (pp.106). F.A. Davis Company

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