Posterolateral Drawer Test

What is the Posterolateral Drawer Test?

The Posterolateral Drawer Test is a clinical examination used to evaluate the integrity of the knee's posterolateral structures, which include the popliteus tendon, lateral collateral ligament, and popliteofibular ligament. This test specifically assesses the stability of the posterolateral corner (PLC) of the knee, which is crucial for preventing excessive backward movement and rotation of the tibia. The test targets several anatomical parts of the knee, including the lateral collateral ligament complex, the popliteofibular ligament, and the lateral femoral condyle.

This test is primarily used for patients who have experienced knee trauma, particularly those involved in sports or activities that place significant stress on the knee. It helps diagnose injuries such as posterolateral corner injuries, which can lead to posterolateral rotatory instability.

Posterolateral rotatory instability is associated with complex knee injuries involving multiple ligaments, including the anterior cruciate ligament (ACL) and medial collateral ligament (MCL). Knee ligament instabilities, especially those in the lateral ligament compartment, can significantly impact a patient's mobility and stability.

The Posterolateral Drawer Test is critical for identifying any injury commonly missed during initial assessments. PLC injuries, if undiagnosed, can contribute to chronic knee pain and functional deficits.

Accurate diagnosis through the Posterolateral Drawer Test is essential for developing effective treatment plans, which may involve physical therapy, bracing, or surgical intervention.

How to perform the Posterolateral Drawer Test

To accurately perform the Posterolateral Drawer Test, follow these steps:

Step 1: Access the template

Begin by accessing the Posterolateral Drawer Test template on the Carepatron app to ensure you have all necessary fields and instructions ready for the test. You can use the template digitally or print it out.

Step 2: Position the patient

Have the patient lie in a supine position on an examination table. Raise the affected knee. Knee flexion must be approximately 80 degrees.

Step 3: Prepare the tibia

Rotate the tibia externally to about 15 degrees. This positioning is crucial for isolating the posterolateral structures of the knee.

Step 4: Apply the force

Place your fingers on the posterolateral aspect of the knee. Apply a posterolateral force to the tibia, pushing it backward. This maneuver assesses for any laxity or excessive movement in the knee joint.

Step 5: Compare with the contralateral side

Perform the same test on the patient’s unaffected knee. Comparing the two sides helps determine the extent of any abnormal movement or instability in the affected knee.

After conducting the test, document the findings accurately in the provided template. Record any observed symptoms or reactions to the applied force.

Results and interpretation of the Posterolateral Drawer Test

The results of the Posterolateral Drawer Test provide valuable insights into the integrity of the knee's posterolateral structures. Here's how to interpret the findings:

• Negative: If the backward movement of the tibia in the affected knee is similar to that of the unaffected knee, the test is considered negative. This indicates that there is no significant laxity or instability in the posterolateral corner of the knee.
• Positive test: If there is excessive backward movement of the tibia relative to the unaffected knee, the test is positive. This suggests that there is laxity in the posterolateral structures of the knee, which may indicate an injury to the ligaments or other supportive tissues in this area: the posterior cruciate ligament (PCL), the lateral collateral ligament (LCL), and/or the PLC.

After a positive test, there are additional steps that should be taken before initiating treatment because the Posterolateral Drawer Test should not be the only assessment performed. These tests include the Dial Test, the Pivot Shift Test (and its reverse variation), the external rotational recurvatum test, and the Varus Stress Test.

Benefits of using our template

Using our Posterolateral Drawer Test template provides several advantages for healthcare professionals:

• Improved patient care: Helps in delivering consistent and high-quality care by ensuring that all necessary steps and observations are documented and easily accessible.
• Time efficiency: Streamlines the process of documenting the test procedure and findings, saving valuable time for healthcare professionals.
• Educational tool: Serves as a valuable resource for training and educating new healthcare professionals about the proper procedure and documentation of the Posterolateral Drawer Test.