Table 1 Standard physical exam procedures used for knee osteoarthritis

Ely’s Test

Subject prone. Examiner stands next to the subject, at the side of the leg that will be tested. Examiner places one hand on lower back, the other holding the leg at the heel. The knee is passively flexed in a rapid fashion. The heel should touch the buttocks. Both sides are tested for symmetry. The test is positive when the heel cannot touch the buttocks, the hip of the tested side rises up from the table, or the patient feels pain or tingling in the back or legs. This procedure assesses the tightness of rectus femoris muscle.

0.46 [30]

Ober Test

Subject lies on the uninvolved side with hip and knee flexed at 90°. Examiner places the knee in 5° of flexion, fully abducts the leg being tested, and then allows gravity to adduct the extremity until the hip cannot adduct any further. The procedure assesses the tightness of the iliotibial band.

0.73 [47]

Lachman's

Examiner flexes the knee to 30° with the patient in supine and applies an anterior force to the tibia, noting any excess motion. The procedure assesses the integrity of the anterior cruciate ligament.

0.36 [48]

Posterior Sag

Examiner flexes the hip and knee to 90° with the patient and assess a possible posterior sag of the tibia. The test assesses the integrity of the posterior cruciate ligament.

Not found

Varus at 30°

The examiner brings the testing knee to 30° and applies a varus force while the subjects is in supine. The examiner notes any excess motion. The procedure assesses the lateral collateral ligament, the fibular collateral ligament and other posterior lateral corner knee structures.

Not found

Valgus at 0/30°

Examiner brings testing knee to 30° and applies a valgus force while the subject is in supine. The examiner notes any excess motion. Then repeats the test with the knee in 0°. This procedure assesses the medial collateral ligaments with or without the posterior capsule.

0.16 [49]

McMurray's

Subject supine. The examiner places one hand to the side of patella and other at distal tibia and extends the knee from maximum flexion to extension with internal rotation and varus stress. The knee is then returned to maximum flexion and the knee extended with external rotation and valgus stress. This procedure assesses meniscal integrity.

0.35 [50]

Apley's (distraction and compression)

Subject is prone with their knee flexed to 90°. The examiner medially and laterally rotates the tibia, combined first with distraction of the lower leg. The examiner then applies an axial load through the knee and rotates the joint via the lower leg. A positive test will result in pain or increased rotation relative to the other side when distraction is applied.

Compression test – the test is positive if the rotation plus compression of patella is more painful or shows decreased rotation relative to the normal side. The distraction test assesses the medial and lateral collateral ligament. The compression test assesses meniscal integrity.

Not found

Waldron Sign

Examiner gently compresses the knee while the subject is squatting, noting any pain or crepitus. This procedure assesses patellofemoral joint and cartilage integrity. A positive test indicates the presence of chondromalacia, patella or anterior knee pain from patella contact pressure.

Not found

Grind Test

Subject supine with knee slightly flexed. The examiner provides distal force at superior border of patella as the patient contracts the quadriceps. Pain production indicates a positive test. The procedure assesses the integrity of the posterior patella and the trochlear groove of the femur.

Not found

Vastus Medialis Oblique Test

Patient supine, knee supported in 20° flexion. Patient actively extends knee. The examiner assesses contraction and movement of patella superiorly into grove. Graded as weak, no contraction or findings were within normal limits

Not found