The anterior draw test is a manoeuvre carried out to assess the integrity and function of the anterior cruciate ligament, which normally prevents anterior glide of the tibia with respect to the femur.
The test involves having the knee flexed to 90ø, with all muscles relaxed. The hands are placed at the top of the calf, and the lower leg is pulled, with the examiner sitting on the foot to prevent movement away from the femur. The end-point of tibial movement reveals most about the anterior cruciate and anything more than a small degree of movement suggests some laxity of the ligament.
If the test is repeated with the leg in 15 degrees of external or internal rotation, increased anterior excursion of the medial or lateral tibial condyle respectively suggests rotatory instability.
There has been recent suggestion that this test only proves positive if the medial collateral ligament is also ruptured. A false positive is obtained if the tibia is already subluxed upon the femur due to posterior ligament tears.
A variation of this test is the posterior drawer.
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