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Lachman’s test is used to detect the presence of anterior cruciate ligament insufficiency. This test is also known as the Trillat’s test and Ritchie’s test.
With the patient in the supine position and the involved knee flexed to 20 to 30 degrees, stabilize the lower femur with one hand, grasp the upper tibia, and then draw the tibia forward.
The test is considered positive if there is an excessive anterior translation of the tibia in comparison to the uninvolved side indicating anterior cruciate ligament insufficiency. This test is considered to be the most sensitive test for acute anterior cruciate ligament injury.
Lachman’s test can be difficult to perform on a larger patient. In these circumstances, a prone variation may be a better option. To perform this variation, the patient lies prone with the knee flexed to 20 to 30 degrees and the lower leg supported by a firm pillow. Grasp the upper posterior tibia and press it forward while the femur is stabilized by the table. Feel for the excessive anterior translation of the tibia suggesting anterior cruciate ligament insufficiency.
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