The Lachman, Anterior Drawer, and Pivot Shift tests assess stability of which joint, and who should perform these tests?

• A. Knee; performed by a trained clinician
• B. Ankle; performed by the athlete
• C. Shoulder; performed by a coach on the field
• D. Hip; performed by any medical assistant

Answer: (A)

These tests evaluate stability of the knee joint, focusing on the ACL and how the tibia moves relative to the femur. The Lachman test looks for forward movement of the tibia with the knee only about 20–30 degrees bent, and it’s highly sensitive for ACL tears because it minimizes hamstring guarding and isolates the ACL. The Anterior Drawer test also checks forward tibial movement but with the knee at 90 degrees, though its accuracy can be reduced if the hamstrings relax or if the setup isn’t stable. The Pivot Shift test examines rotational stability by applying valgus stress and internal rotation as the knee is flexed, reproducing a clunk or shift that signals an ACL injury with rotational laxity.

Who should perform these tests? A trained clinician—such as a sports medicine physician, athletic trainer, physical therapist, or other qualified examiner—has the proper technique, hand placement, knee stabilization, and experience to safely perform the maneuvers and accurately interpret the end feel and amount of laxity. They’re not tests for an untrained person on the field or an athlete to perform themselves.