Dr. Kevin Yip

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

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Lateral shearing

Significance

This test is used to detect internal derangement at the outer side of the knee.

Positioning.

The subject lies in the supine position,with the knee flexed to a right angle and
the heel resting on the couch. The examiner sits opposite the subject at the foot-end of the couch. The heel of the ipsilateral hand is placed at the medial tibial condyle. The heel of the contralateral hand is placed at the lateral femoral condyle. The fingers of both hands are interlocked.

Procedure.

Apply a strong shearing strain that forces the tibia laterally on the femur.

Common mistakes.

The hands are not high enough on the femur or low enough on the tibia
respectively.

Normal functional anatomy:

• Range: no movement can be elicited in a normal knee
• End-feel: hard ligamentous
• Limiting structures:

– articular surfaces
– intercondylar spines of the tibia
– menisci
– posterior cruciate ligament.

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