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First published on January 24, 2008, doi:10.1177/0363546507312641
This version was published on March 1, 2008
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The American Journal of Sports Medicine 36:577-594 (2008)
© 2008 American Orthopaedic Society for Sports Medicine

Clinical Sports Medicine Update

Current Concepts Review

Comprehensive Physical Examination for Instability of the Knee

James H. Lubowitz, MD{dagger},*, Brad J. Bernardini, MD{dagger},{ddagger} and John B. Reid, III, MD{dagger}

From the {dagger} Taos Orthopaedic Institute Research Foundation, Taos, New Mexico, and the {ddagger} South Jersey Center for Orthopedics and Sports Medicine, Vineland, New Jersey

* Address correspondence to James H. Lubowitz, MD, Taos Orthopaedic Institute Research Foundation, 1219-A Gusdorf Road, Taos, NM 87571 (e-mail: jlubowitz{at}kitcarson.net).

A careful history and physical examination are the cornerstones of orthopaedic sports medicine. When evaluating a patient for ligamentous instability of the knee joint, an understanding of the contribution of anatomic structures to stability enhances a practitioner’s ability to achieve an accurate clinical diagnosis. This article reviews the various types of knee instability and the associated anatomic structures. Ultimately, information must be obtained from multiple tests to reach the final diagnosis. We describe in detail the pathologic and biomechanical basis of the tests for both tibiofemoral and patellofemoral instability of the knee joint and provide recommendations for performance and interpretation of these physical examinations.

Key Words: knee • instability • examination • diagnosis • anatomy • biomechanics






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