Anterior Drawer Test – Orthopedic Examination of the Knee

To better understand the mechanics of this test and why it is effective, you may want to review basic knee anatomy.

What is the Anterior Drawer Test of the Knee?

The Anterior Drawer Test is commonly used in orthopedic examinations to test for anterior cruciate ligament (ACL) tears. It is one of the most well known and most used special tests in orthopedics and is also one of the easiest to perform.

Involved Structures

  • anterior cruciate ligament (ACL)
Ruptured Anterior Cruciate Ligament (ACL)
Ruptured Anterior Cruciate Ligament (ACL)

Starting Position

The test is performed with the patient in a relaxed supine position with knees bent to approximately 90 degrees. The examiner sits on the both feet of the subject and places his hands around the upper tibia of one leg. The thumbs of both hands are on the supero-anterior aspect of tibia.

Test Movement

From the starting position the examiner pulls anteriorly on the proximal tibia.

Positive Anterior Drawer Test

This test is considered positive if there is a soft end feel to the translation of the tibia. A soft end feel / endpoint is indicative of secondary structures stopping the continued anterior translation of the tibia. Excessive anterior translation should also be noted. A hard/firm end feel will be felt when the ACL is intact and abruptly halts continued anterior translation. The positiveness of the test is determined by end feel and also by the amount of translation. The examiner should do the same test movement on the other leg as comparison. This is easy to do from the same starting position, seated on the subjects feet.

Accuracy/Reliability of the Anterior Drawer Test

The Anterior Drawer Test is fairly accurate but has been shown in a number of studies to be less accurate than the Lachman Test and the Pivot Shift Test.

Video Demonstration

video source: mdofola

>> Return to the list of Common Tests in Orthopaedic Examination of the Knee

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