Dr. Kevin Yip

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

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PASSIVE TESTS-Passive flexion

Positioning.

The subject lies in the supine position with extended legs. The examiner stands
level with the subject’s knee. One hand grasps the distal part of the leg, just proximal to the malleoli; the other hand grasps the knee at the medial femoral condyle.

Procedure.

Move the extended leg upwards until the knee can be flexed with a simultaneous
movement of both hands. Once the flexion has begun, the distal hand continues the movement while the proximal hand just stabilizes the femur
in a sagittal plane but allows hip flexion.

Common mistakes.

None.

Normal functional anatomy:

• Range: 1700
• End-feel: soft tissue approximation
• Limitillg structures: approximation of calf muscles and hamstrings.

Common pathological situations.

Numerous conditions lead to limitation in flexion of the knee: capsular lesions, ligamentous adhesions, internal derangement and extra-articular conditions.
Diagnosis depends on the pattern that emerges after the completion of the other tests and on the end-feel. A spastic end-feel is typical for acute arthritis or haemarthrosis; a hard endfeel is suggestive of arthrosis, a springy block
indicates internal derangement and a soft ligamentous end-feel may be caused by ligamentous adhesions.

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