Physical diagnostic tests for assessing ruptures of the anterior cruciate ligament.

Anterior drawer test: This test is performed with the knee flexed to approximately 90 degrees. Ideally, the patient’s foot should point straight ahead and be secured by sitting directly on the toes of the patient. The examiner’s hands are placed around the proximal tibia with the thumbs placed on the tibial tubercle. A gentle to and fro rocking motion is performed to determine the degree of anterior translation of the tibia compared to the femur. It is essential to ensure that the patient has completely relaxed the hamstrings to prevent a potential false negative result. Increased anterior translation of the injured knee (compared to the normal contralateral knee) would be indicative of a potential anterior cruciate ligament (ACL) rupture, deficient posterior horns of the menisci, or meniscocapsular tears (or any combination of these).