Video – Posterior Sag Sign

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Posterior Sag Sign

The Posterior Sag Sign indicates the presence of a posterior cruciate ligament tear.

To look for this sign, the patient lies supine with their hips flexed to 45˚ and their knees flexed to 90˚. Normally, the medial tibial plateau lies at least 1 cm anterior to the femoral condyle when viewed directly from the side. A posterior sag sign is present when an indentation is seen as a result of a posteriorly displaced tibia indicating a posterior cruciate ligament tear.

It’s important that the examiner recognizes this sign prior to performing an anterior drawer test as failure to do so can give the impression that the tibia displaces excessively forward leading to the false conclusion that the anterior cruciate ligament is deficient. The anterior drawer test is described in a separate video.

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