Tests For Examination Of The Knee - Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim’s educational animated video describes test for evaluation of knee injuries and all the maneuvers you need to know to preform an excellent knee examination.
McMurray’s test is a knee examination test that elicits pain or a painful click as the knee is brought from flexion to extension with either internal or external rotation. The McMurray’s test uses the tibia to trap the meniscus between the femoral condyle and the tibia.
When performing the McMurray’s test, the patient should be lying supine with the knee flexed. The examiner grasps the patient’s heel with one hand and places the other hand over the knee joint. To test the medial meniscus, the knee is fully flexed and the examiner then passively externally rotates the tibia and places a valgus force. The knee is then extended in order to test the medial meniscus. to tests the lateral meniscus, the examiner passively internally rotates the tibia and places a varus force. The knee is then extended in order to test the lateral meniscus. A positive test is indicated by pain, clicking or popping within the joint and may signal a tear of either the medial or lateral meniscus when the knee is brought from flexion to extension.
Lachman’s test is the most sensitive and best test for examining an ACL injury. The patient should be lying supine and completely relaxed. Make sure that the patient’s hip, quadriceps and hamstring muscles are all relaxed. Bend the knee to about 20-30°. Stabilize the femur with one hand and with the other hand, pull the tibia anteriorly and posteriorly against the femur. With an intact ACL as the tibia is pulled forward the examiner should feel an endpoint. If the ACL is ruptured, the ACL will be lax and the examination will feel softer with no endpoint. The tibia can be pulled forward more than normal (anterior translation).
Both the Lachman’s test and the Pivot shift test are associated with 20-30°s of knee flexion. The Lachman’s test starts at 20-30 ° of flexion. With the Pivot shift test you feel the clunk at 20-30°s of flexion. 20-30°s of flexion is important for examination of the ACL (remember that). The patient should be lying supine. Make sure the patient is totally relaxed. With pivot shift, the knee is in the subluxed position and the knee is in full extension. The pivot shift starts with extension of the knee and you can feel the clunk at 20-30° of flexion. Hold the knee in full extension then add valgus force plus internal rotation of the tibia to increase the rotational instability of the knee. Then take the knee into flexion. A palpable clunk is very specific of an ACL tear. the iliotibial band will reduce the tibia and create the clunk on the outside of the knee. Always compare with the other side.
The reverse pivot shift test helps to diagnose acute or chronic posterolateral instability of the knee. A significantly positive reverse pivot shift test suggests that the PCL, the LCL, the arcuate complex and the popliteofibular ligament are all torn.
The reverse pivot shift test begins with the patient supine with the knee in 90° flexion. Valgus stress is then applied to the knee with an external rotation force. Bring the knee from 90°s of flexion to full extension. The tibia reduces from a posterior subluxed position at about 20°s of flexion. A shift and reduction of the lateral tibial plateau can be felt as it moves anteriorly from a posteriorly subluxed position. A clunk occurs as the knee is extended. This is called reverse pivot shift because shift of the lateral tibial plateau occurs in the opposite direction of the true pivot shift (Seen in ACL tears). If the tibia is posterolaterally subluxed, the iliotibial band will reduce the knee as the IT band transitions form a flexor to extensor of the knee. It is very important to compare this tests to the contralateral knee. Pivot shift = ACL tear
The test is done with the patient in supine position and the knee is flexed to 90°. The examiner stabilizes the foot. Next the examiner pushes backward on the tibia, looking for the tibia to sag posteriorly. Observer the sag that develops due to tear of the posterior cruciate ligament (PCL). The amount of translation in relationship to the femur is observed. The test is considered positive if excessive posterior translation of the tibia is demonstrated.
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Background music provided as a free download from KZbin Audio Library.
Song Title: Every Step

[@Adam-kt4qf]

this is the best knee exam test video I have ever seen. thank you very.

[@OKTJM]

Nice video, not only explaining the different tipes of test done on the knee, but adding latin expresions of different parts of the knee itself, thank you !!!!

[@faithpieters9228]

Brillant thank you sharing this information with 3rd year undergraduate nursing students so informative and easy to follow

[@venezuelaavi]

Great video dr Ebraheim thank you

[@mariobelalla9762]

Thank you , your videos are truly helpful I have learned so much by those vids and make me understand even better things that I couldn't get in school

[@melaniepenner2172]

Great Music. Put my dog soundly to sleep while I was watching the video!

[@Caperhere]

I bet that is the doctor himself playing the piano.🎼

[@JohnGibbons]

Brilliant video and thanks for sharing. Regards John Gibbons

[@donnagracehogan7468]

Thank you! Amazing and beautifully presented.

[@heahchengsta]

A lot of effort has been put in to produce this video. Thank you for putting in the time!

[@wx7yamaha]

I found this was the best analysis of knee injury I've ever seen.😊

[@kayefromthebay]

Thank you so much for this doc!!!! helping us become better providers

[@mcgaula]

As an NP student, and watching numerous videos, yours thus far has been the most informative. Thank you for putting this together

[@Caperhere]

Thank you for grasping his teaching. If I was seeking help for pain, it would be comforting to know I was being diagnosed and treated by medical personnel who studied Doctor Ebraheim’s videos.

[@southerngentspokane]

The best video on knee examination. It's amazing that this video using animation is better than other videos using live subject demonstrations! Thank you for helping me in my studies.

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[@IamPhysio]

thats Good

[@kaia06]

Love Your videos Dr. Nabil! Very educational :)

[@kishorjoshimd2738]

Thank you Dr. Nabil for your great video. I watched numerous videos to try to understand for few months, yet was confused. This video cleared all confusions

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these video transition in Telugu please

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[@mahdibehrouznezhad3787]

It's touchable. Thank you for helping me in my studies

[@YaTaSay]

Thank you Dr. I had a dual Meniscus Tear repair, then someone injured me 2 months post op, which cause some type of "accelerated arthritis" I've never heard of, however it resulted in a TKR. The Doctor wishes to do my other knee but as long as I can function without a brace, or in a brace I do not wish to go through that surgery again. I've had quite a few major surgeries, four of which have been Spine, yet the TKR was one of the most painful. Even worse than having my shoulder ( Torn Rotator, reattached bicept and clavical with several anchors ). It took me two 1/2 years to regain nearly 90% use, 8 months was spent in actual PT. Still that knee really was difficult. I have kept to non-evasive measures of injections & PT and exercise. Ice and rest when overused. But it's great you're putting these informative videos out here.

[@neokaichin]

Brilliant Thanks for your videos.

[@victorcorneliosr5334]

Many thanks Doc for the valuable video.

[@dkz251]

Thank you! So helpful.

[@khyati297]

Helpful to eaisly understand ...thank you so much😊

[@bobolatrick]

Best videos on KZbin

[@Sun432]

Thank you so much for this!

[@stevieb82]

best played with NO SOUND.

[@emanalam9380]

The best video i watshed for few videos ..thank you Dr.

[@Physio-KB]

thank you sir i see regularly your every post

[@pariapourmalek4420]

Thank you!

[@befekadudemmissie4592]

I am thoroughly intrested and satisfied with all of your presentations that I viewed ! !

[@GuitarType01]

This was very helpful

[@thienhunk]

Thank you sir, the video is extraordinary

[@sanjigaiambalam3481]

Thank you dr.. Very nice.. Easily understandable videos

[@fisioterapimandala]

Great clear tutorial 👍🏼👍🏼 Usefull clinically

[@ful36]

Thank you so much.

[@mosheeeer]

thank you Dr Nabil

[@DOC7ORT]

Excellent demonstration!

[@user-hy8zj8jj8h]

thank you

[@PASS116]

thank you so much!

[@MrJabirmansuri]

Thanks, jazakallah

[@chiara7467]

Thank you, this cured my insomnia ❤️

[@danielbohn]

Awesome! Ty, doctor 🙏🇧🇷

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Thank you very much

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Thank you prof

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Those are great!

[@geojor]

thanx...

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Thx you so much!

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great thanks to you doctor.

[@kavithakavitha8667]

Superb video Sir.

[@sergioamparan3577]

Thank you.

[@patestrella7131]

Nicely done.

[@derekhtroop3935]

Thank you. God bless you

[@ShyamKumar-fw7dj]

Awesome...

[@LK.Gamer.56]

Thanks for this vdo and i watching again

[@sanjigaiambalam3481]

Thank you sir

[@Rockstar-zb7gi]

Very informative...

[@josef994]

So Amazing 7 * thanks for this video bro

[@lokeshvarada5027]

Good work

[@munir777]

thanx alot

[@IRFANKHAN-yg2jv]

Thank u doctor

[@avijitsarker0242]

Thank you so much 😇😇😇😇

[@ramyachitu9785]

It was very useful my knowledge

[@saeedelgazzar4895]

very very good d/ nabil

[@drgadham]

Very good ❤

[@daisyda3037]

Great help for physio🙆🏼

[@evehawasow2527]

Pédagogique Excellent Tanks Dr

[@RizwanKhan-xk2yq]

thanks sir

[@hibanabil1595]

goooooooooood thank you

[@analytiskpsykoterapi4270]

BEST EDUC. MATERIAL I EVER CAME ACROSS THANK YOU DR. NABIL ! !

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[@gretchenpeppers6304]

Thank you for making these amazingggg videos! I know its helping me study to pass the boards!!

[@user-ym3ip3bo1t]

awesome

[@anyareas]

Thank you Dr. Nabil Ebraheim for sharing these videos!!. Regards (Physiotherapist)

[@saravananpalanimuthu8793]

Best!

[@paolamanzano424]

Spectacular!!! excellent job!

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So nice sir

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cảm ơn bác sỹ

[@MrChirahill]

Nice

[@Bitly24]

Thx

[@TheAcid03]

Спасибо, это великолепно!

[@eddienichols6863]

much thanks ,

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abdullah aljalili بس مفيش عربى ممكن ترجمه

[@esperanzajoachin8101]

Gracias Gracias Gracias

[@abdullgafooralrawi6865]

this video is very clear and useful thank you a lot Dr.Nebil

[@xuyenxaophcn.8322]

Thanks you shared, welcom

[@shananarocks]

Thanks for your excellent illustration and animation not only for the public but for the lousy orthopedic doctors too. My so-called specialist head of a public hospital does not even allow any X-ray or MRI despite my earlier meniscus surgery repair some in another hospital in 2008. He merely dismiss it as arthritis and tell me so what if he find broken pieces of cartilages inside. I think he was rushing to play golf with his rich friends to network and not be of service to the public.

[@mukenamunalula296]

superb and handy

[@galkacyowadankaygi4892]

mukena munalula

[@brittvaughn9447]

For McMurray, wouldn't varus place stress on the medial compartment and valgus on the lateral? In valgus, the foot goes out, crunching down on the outside and putting tension on the inside. Am I imagining this wrong?

[@atlas5125]

The best

[@pipeliner188]

When it shows only one knee i dont know which is the inside or outside of the knee the mcl is on, not very helpful to me

[@sanketshah7377]

God bless you

Very good!!!

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[@NomaanSyed]

Thank you Sir!

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Nomaan Syed

[@UmeshKumar-vm8fg]

The all best vedio

[@esperanzajoachin8101]

Aunque esté en inglés es excelente gracias gracias gracias

[@CosmopolitanView]

Dear Nabil Ebraheim, when testing the lateral meniscus - why do I bring varus force on the knee joint?Biomechanically, I normally do have more stress on the medial meniscus during a varus force in the knee joint. So, shouldn't I better bring valgus force on the meniscus when testing and provoking the lateral part of it? Best!

[@masoodkhan_894]

Kindly suggest me right things for chondromalsia pettela. I had an orthoscopy 2 months before but not satisfied.

[@petit7228]

Sir what's the best injection for wear and tear cartilage of the knees. Is there no side effects? Thank you

[@jaisriram537]

It's clearly explains about the knee problem s

[@relaxingsoul9608]

Sir please put videos for other examination like foot and ankle, neck, spine

[@instamedschool8452]

Thanku sir

[@yaithoibalaishram238]

Dr, my knee is having problem as same as the RUPTURED ACL. Whenever i play i face this same problem on my knee. I didn't go the hospital(about 3 yrs). How can i do treatment.