Physical Exam

Knee Anterior Drawer

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Video coming September 2026

How to Perform

With the patient supine, the hip flexed to 45° and the knee flexed to 90°, stabilize the foot, grasp the proximal tibia with both hands, and pull it forward relative to the femur. Compare both sides. A positive test is increased forward translation compared with the other knee.

How to Interpret

Anterior Cruciate Ligament Tear

Composite anterior cruciate ligament examination positive (Lachman, anterior drawer, and pivot shift)

Rule in

Very helpfulDerived CI

Rule out

Very helpfulDerived CI

Evidence:Strong

Anterior drawer test positive

Rule in

Helpful

Rule out

Helpful

Evidence:Strong

References

Sokal PA, Norris R, Maddox TW, Oldershaw RA. The diagnostic accuracy of clinical tests for anterior cruciate ligament tears are comparable but the Lachman test has been previously overestimated: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2022;30(10):3287-3303. doi:10.1007/s00167-022-06898-4. PMID: 35150292. PMC9464183 (open access CC BY 4.0).
Solomon DH, Simel DL, Bates DW, Katz JN, Schaffer JL. The rational clinical examination. Does this patient have a torn meniscus or ligament of the knee? Value of the physical examination. JAMA. 2001;286(13):1610-1620. doi:10.1001/jama.286.13.1610. PMID: 11585485.
McGee S. Evidence-Based Physical Diagnosis. 6th ed. Philadelphia, PA: Elsevier; 2025.

Research last updated September 10, 2026.