Name of test



Quadriceps active test

What it tests



Demonstrates PCL deficiency

How to do it



Have the patient lie supine with the hip and knee flexed 90 degrees. You may help by supporting the foot, which is obviously now 1 femur-length off the table. The patient may find it easier to hold the hip flexed by cradling both hands under the thigh.

Ask the patient to actively extend the leg; observe.

The normal response



The knee appears to "hinge" as the leg extends.

What it means if not normal



If the pcl were deficient, the knee would NOT be in a normal position at the start of the test: the tibia would be subluxated posteriorly (sagging) as there is no pcl to hold it in place. Thus, when the quad fires to extend the knee, its first action is to pull the tibia back to its normal place (given that the quad attaches to the anterior tibia via the patellar tendon), and only thereafter extends the knee joint.

Comments



This test is striking only with significant posterior displacement. Also, in the acutely injured (and swollen) knee, a positive test may not be obvious.

Citations





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Figures