Knee Orthopaedic Test: Lever Sign Test
May 27, 2023The Lever Sign Test is a physical examination maneuver used to diagnose anterior cruciate ligament (ACL) injuries in the knee. Here are the steps to perform the Lever Sign Test:
- Ask the patient to lie flat on their back with their legs straight.
- Bend the patient's affected knee to a 90-degree angle.
- Place your hands on the patient's upper tibia and lower femur to stabilize the knee joint.
- With your other hand, grasp the patient's heel and pull it towards their buttocks, while pushing the patient's thigh downwards.
- Observe the movement of the tibia in relation to the femur.
- A positive Lever Sign Test is indicated by anterior tibial translation or movement of the tibia forward in relation to the femur. This indicates a possible ACL injury.
References:
- Hegedus EJ, Cook C, Hasselblad V, Goode A, McCrory DC. Physical examination tests for assessing a torn meniscus in the knee: a systematic review with meta-analysis. J Orthop Sports Phys Ther. 2007 Nov;37(11):541-50. doi: 10.2519/jospt.2007.2337. PMID: 18021597.
- Kopkow C, Freiberg A, Kirschner S, et al. Reliability and diagnostic accuracy of the clinical examination and patient self-report measures for medial meniscus posterior horn tears. Knee Surg Sports Traumatol Arthrosc. 2017;25(5):1525-1531. doi:10.1007/s00167-016-4358-1
- Magee, D. J. (2018). Orthopedic physical assessment. Elsevier Health Sciences.
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