The drawer test is used to diagnose cruciate ligament tears in the knee. There are two types: anterior and posterior. The Lachman test is a variation. Treatment depends on the severity of the injury.
The drawer test is often administered by doctors when diagnosing a cruciate ligament tear in the knee. The patient lies on the bed with the knees raised to a 90° angle. The clinician, seated on the patient’s feet, will pull the patient’s tibia forward or backward depending on the type of drawer test being administered. A shinbone that yields to a doctor’s movements more easily than normal usually indicates that the anterior or posterior cruciate ligament is torn. If the patient’s knee is in a 30-degree angle instead of a 90-degree angle, doctors do a variation of the drawer test known as the Lachman test.
There are two types of this type of test: anterior and posterior. The anterior drawer test is used to check for an anterior cruciate ligament tear. The back test assesses whether or not the posterior cruciate ligament is injured. While most often performed on the knee, the drawer test can also be used on the ankle, shoulder, and elbow.
When performing this test, the examining physician usually directs the patient to lie down on the examination table. The patient, with his feet resting on the bed, pulls the affected knee up to a 90° angle. Once the doctor has verified that the patient’s hamstrings are relaxed, the doctor usually sits on the patient’s feet and grips the shinbone. If you do an anterior drawer test, the doctor will gently pull the tibia forward as if he or she is trying to open a drawer. For a posterior examination, the tibia is pushed back, as if closing the drawer.
If the patient’s tibia moves forward or backward more than the normal range of motion should be, a cruciate ligament tear is likely. For most clinicians, more than five millimeters of anterior or posterior motion will indicate a ligament tear. A drawer test that produces this type of result is considered positive.
The Lachman test is a variation of the drawer test. Instead of placing the patient’s knee at a 90° angle, the doctor positions it at a 30° angle. Once the femur has been stabilized, the doctor grasps the tibia and gently pulls it towards, or pushes, away from your body, at the doctor. The Lachman test is thought to be the more delicate of the two types of exams.
Treatment of a torn cruciate ligament depends on the severity of the injury. A minor injury may require rehabilitation rather than surgery. The goal is to strengthen nearby muscles to compensate for the injured ligament. A larger lesion often requires reconstructive surgery and post-surgical rehabilitation. Regular exercise designed to strengthen the muscles surrounding the cruciate ligaments can help prevent ligament injuries.
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