Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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FUNCTIONAL EXAMINATION OF THE KNEE

Introduction/general remarks

The knee is the largest and most complex joint of the human body. Because it is situated at the ends of two long lever arms it is very well suited to clinical testing. Furthermore, the joint is relatively uncovered by muscles which facilitates palpation of most structures, intra-articular structures excluded.

One should warn against too many different tests. It is important to realize that the quality of a clinical examination does not depend on the number of tests performed but on the accuracy of performance of the most important tests.
Diagnosis of a particular lesion also does not rely on the presence of one pathognomonic test but on the complete clinical picture (the sum of positive and negative answers after the performance of a set of important standardized tests).

For instance, none of the so-called pathognomonic meniscus tests has a high positive predicting value (between 21 and 50%) which means that in more than half of the subjects with a positive meniscus test, no meniscai lesion is found on arthroscopy. Also, the presence of a positive instability test has only value if it is interpreted in relation to the rest of the clinical evaluation.

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