Appropriate physical exam is important in diagnosing ACL injuries and concomitant pathology and should also be performed including at a minimum: a neurovascular exam with documentation of both distal perfusion and tibial/peroneal nerve function, assessment for joint line tenderness or obvious step off/deformity, evaluation for an effusion, assessment of varus and valgus laxity at 0 and 30 degrees of extension, evaluation of anterior-posterior and rotational laxity. 8, 32, 58, 104, 105 Lachman’s test should be performed and has been shown to be sensitive for ACL injury.23
Benefits of Implementation
A thorough history and physical exam will assist the practitioner in prompt and accurate diagnosis of ACL injuries and concomitant pathology.
Possible Harms of Implementation
There are no known harms associated with appropriate implementation of this recommendation.
Future research could help confirm the most useful history and physical exam findings for the diagnosis of ACL injury and concomitant pathology.
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