Lachman Test
Other Names
- Lachman Test
- Lachman’s Test
- Drop Leg Lachman Test
- Lachman-Trillat Test
- Modified Lachman's Test
- No Touch Lachman Test
- Richie Test
- Trillat Test
- Lachman maneuver
- Lachman examination
- ACL Lachman test
Purpose
- Assess integrity of Anterior Cruciate Ligament
- Named after John W. Lachman, an American orthopedic surgeon (need citation)
Description
- Patient is supine in examination table
- Knee is flexed to 20-30°
- One hand is placed behind the tibia, the other on the patients thigh
- The examiner should attempt to translate the tibia anteriorly relative to the femur
- Comparison should be made to the unaffected knee
- Positive exam is
- Anterior translation
- with or without an end-point
- >2mm anterior translation
Drop Leg Lachman Test
- Modified version of the test
- The patients ipsilateral knee hangs off the examination table
- Examiner can stabilize the limb by placing the ankle between their thighs
- Test is otherwise performed the same
No Touch Lachman Test
- The patient grasps the posterior thigh, just proximal to the knee
- The knee is allowed to flex slightly
- The patient is asked to raise the lower leg while examining flexion
- Positive test
- Anterior displacement of the tibia
Prone Lachman Test
- The patient is prone
- The examiner stabilizes the distal leg with her thigh
- Provides an anterior force on the proximal aspect of the posterior tibia
Pathology
Evidence
- Katz et al[4]
- Injury less than 2 weeks prior to examination (acute)
- Sensitivity: 77.7%
- Specificity: >95%
- Injury greater than 2 weeks prior to examination (subacute, chronic)
- Sensitivity: 84.6%
- Specificity: >95%
- Injury less than 2 weeks prior to examination (acute)
- Benjaminse et al Meta-analysis of studies looking at value of special tests[5]
- Sensitivity of 85% (95% CI, 83–87)
- Specificity of 94% (95% CI, 92-95)
- Blanke et al[6]
- Sensitivity: 74%
- Specificity: 83%
- PPV: 81%
- NPV: 76%
- LR+: 4.4
- LR-: 0.31
See Also
References
- ↑ Almoallim, Hani, et al. "Approach to Musculoskeletal Examination." Skills in Rheumatology (2021): 17-65.
- ↑ Iyer, K. Mohan, Abhishek Vaish, and Raju Vaishya. "Anterior Cruciate Ligament Injuries of the Knee." Introduction to Limb Arthrology. Jenny Stanford Publishing, 2023. 327-342.
- ↑ Mulligan, Edward P., Jordan L. Harwell, and William J. Robertson. "Reliability and diagnostic accuracy of the Lachman test performed in a prone position." journal of orthopaedic & sports physical therapy 41.10 (2011): 749-757.
- ↑ Katz JW, Fingeroth RJ. The diagnostic accuracy of ruptures of the anterior cruciate ligament comparing the Lachman test, the anterior drawer sign, and the pivot shift test in acute and chronic knee injuries. The American Journal of Sports Medicine 1986;14:88-91.
- ↑ Benjaminse, Anne, Alli Gokeler, and Cees P. van der Schans. "Clinical diagnosis of an anterior cruciate ligament rupture: a meta-analysis." Journal of orthopaedic & sports physical therapy 36.5 (2006): 267-288.
- ↑ Blanke, Fabian, et al. "The forced active buckling sign: a new clinical test for the diagnosis of ACL insufficiency." The journal of knee surgery 33.01 (2020): 042-047.
Created by:
John Kiel on 9 July 2019 13:16:44
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Last edited:
19 January 2026 02:16:26
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