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Varus Stress Test
The Varus Stress test is used to detect the presence of insufficiency of the lateral compartment of the knee, particularly the lateral collateral ligament.
The Varus Stress test is conducted with the knee in two positions:
The test is first performed with the knee in full extension. With the patient in the supine position, stand on the inside of the leg and support it between your arm and body with one hand supporting the calf, while the other holding the lower inner thigh. Apply a varus stress by using the thigh contact as a fulcrum and using the body to lever the lower leg inwards. Observe for the extent of adduction and gapping on the lateral side of the knee.
The test is then repeated with 30 degrees of knee flexion.
The Varus Stress test is positive if adduction and gapping are greater than the uninvolved side with or without pain.
If the test is positive with the knee flexed to 30 degrees but negative with the knee fully extended, the lateral collateral ligament is damaged.
If the test is positive with the knee at both 30 degrees of flexion and at full extension, a number of structures are implicated including:
• Lateral collateral ligament
• Anterior cruciate ligament
• Posterior cruciate ligament
• Posterolateral capsule
• Iliotibial band
The severity of the injury is indicated by the extent of gapping:
- Grade 1 is when the gapping is less than 5 mm
- Grade 2 is when gapping is between 5 and 10mm
- and Grade 3 is when gapping is greater than 10 mm
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