Foot and Ankle International
Tracking Pixel
presents
Wheeless' Textbook of Orthopaedics

Lachman Test



- See:
      - Anterior Cruciate Ligament
      - Anterolateral Rotatory Instability
      - Clunk Test
      - Losee Test
      - Pivot shift

- Discussion:
    - this is a variant of the anterior drawer test, in which the examination is carried out w/ the knee
           in 15 deg of flexion, and external rotation (relaxes the IT band);
    - for a right knee, the examiner's right hand grips the inner aspect of the calf and the left hand grasps
           the outer aspect of the distal thigh;
    - attempt to quantify the displacement in mm (comparing this displacement to the normal side);
    - end point should be graded as hard or soft;
           - end point is said to be hard when the ACL abruptly halts the forward motion of the tibia on the femur;
           - end point is soft when there is no ACL & restraints are more elastic secondary stabilizers;

             

- Definition of Severity:
    - clinical exam:
          - mild: 0 to 5 mm laxity (greater than the uninvolved side)
          - moderate: 6 to 10 mm laxity (greater than the uninvolved side)
          - severe: 11 to 15 mm laxity (greater than the uninvolved side)
                  - when exam reveals such a large amount of translation always consider concomitant MCL tear / meniscal tear;
    - KT-1000:
          - greater than 11 mm of anterior translation of the injured side or greater than 3 mm of side to side
                  difference (delta lachman) indicates ACL tear;
          - following ACL reconstruction, laxity should be less than 3 mm compared to opposite side;




Lachman test evaluated. Quantification of a clinical observation.

Injury to the anterior cruciate ligament producing the pivot-shift sign.

Long-term functional results in patients with anterolateral rotatory instability treated by iliotibial band transfer.

Arthrometric evaluation of knees that have torn anterior cruciate ligament.
     BR Bach et al. JBJS Vol 72-A. No 9. Oct 1990. No 1306.

What Really Happens During the Lachman Test? A Dynamic MRI Analysis of Tibiofemoral Motion.
















Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Wednesday, December 3, 2008 11:35 am