From the Guidelines
A normal left knee assessment reveals full range of motion with flexion to approximately 135 degrees and extension to 0 degrees without pain or limitation. The knee appears symmetrical compared to the right, without swelling, erythema, or deformity. Palpation of the joint line, patella, and surrounding structures elicits no tenderness. Special tests including the anterior and posterior drawer tests, valgus and varus stress tests, McMurray's test, and Lachman's test are all negative, indicating intact ligaments and menisci 1. The patella tracks normally without apprehension or crepitus. Muscle strength testing shows 5/5 strength in quadriceps and hamstrings. Neurovascular status is intact with normal sensation throughout the distribution of femoral and sciatic nerves, and distal pulses are strong and equal. The patient can bear weight fully on the left leg and demonstrates a normal gait pattern without limping or compensation.
Some key points to consider in a normal left knee assessment include:
- Full range of motion without pain or limitation
- No swelling, erythema, or deformity
- No tenderness on palpation of the joint line, patella, and surrounding structures
- Negative special tests indicating intact ligaments and menisci
- Normal patellar tracking without apprehension or crepitus
- Normal muscle strength and neurovascular status
- Normal gait pattern without limping or compensation.
It's worth noting that the provided evidence 1 discusses osteoarthritis of the knee and its management, but does not directly relate to normal knee assessment findings. However, understanding the potential causes of knee pain and disability, such as osteoarthritis, can inform the assessment and management of knee conditions.
From the Research
Left Knee Assessment Normal Findings
Normal findings in a left knee assessment include:
- No signs of anterior cruciate ligament (ACL) injury, as confirmed by tests such as the Lachman test, anterior drawer test, and pivot shift test 2, 3, 4, 5
- Normal laxity in the knee joint, with no significant differences in antero-posterior and rotational laxity compared to the contralateral knee 2
- No evidence of posterior cruciate ligament (PCL) deficiency or injury, as assessed by tests such as the posterior drawer test 6
- Normal joint kinematics and no signs of joint laxity or instability 6
Clinical Tests for Knee Assessment
The following clinical tests are commonly used to assess knee function and diagnose ACL injuries:
- Lachman test: sensitive and specific for diagnosing ACL injuries, especially in acute settings 3, 4, 5
- Anterior drawer test: less sensitive than the Lachman test, but still useful for diagnosing ACL injuries 4, 5
- Pivot shift test: sensitive and specific for diagnosing ACL injuries, especially in acute settings 3, 4, 5
- Posterior drawer test: used to assess PCL functionality and knee joint laxity 6
Diagnostic Accuracy of Clinical Tests
The diagnostic accuracy of clinical tests for ACL injuries is as follows:
- Lachman test: sensitivity of 81.8-90%, specificity of 87.5-96.8% 3, 4, 5
- Anterior drawer test: sensitivity of 40.9-88.57%, specificity of 87.50-95.2% 4, 5
- Pivot shift test: sensitivity of 81.8-88.8%, specificity of 95-98.4% 3, 4, 5
- MRI: sensitivity of 98.57%, specificity of 87.50%, diagnostic accuracy of 96.51% 4