Physical Exam

Lachman

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Video coming September 2026

How to Perform

With the patient supine and the knee flexed to about 20–30°, support and stabilize the distal femur with one hand so the leg remains relaxed, and grasp the proximal tibia with the other. Pull the tibia anteriorly on the femur. Compare with the opposite knee, noting the amount of anterior translation and the firmness of the endpoint.

How to Interpret

Anterior Cruciate Ligament Tear

Any 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

Lachman test positive

Rule in

Helpful

Rule out

Somewhat 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.
Torg JS, Conrad W, Kalen V. Clinical diagnosis of anterior cruciate ligament instability in the athlete. Am J Sports Med. 1976;4(2):84-93.

Research last updated September 10, 2026.