Hughston’s Posteromedial & Posterolateral Drawer Test

• This test is used by doctors the check knee rotatory stability.
• It is performed in to examination part of the assessment.
• This test is performed when the patient complains of knee pain.

What is the purpose of this test?

• This test is used to check the posteromedial & posterolateral rotatory instability of to knee.

How to perform this test?

First part of this test :

• Test position of patient is supine.
• Into supine positive with to knee is flexed up to 80’to 90′ & hip flexed to 45 ‘.
• Then examine medially rotates to patient’s foot slightly & sits on to stabilize it.
• Examiner is pushes to tibia posteriorly.
• If to tibia move/rotates posteriorly onto medial aspect an excessive amount relative to normal knee.
• Medial tubercle rotates posteriory around the PCL means posterior cruciate ligament when the tibia is in mild medial rotation.
• If the posterior cruciate ligament is also torn, the posteriormedial movement is greater & tibia subluxates posteriorly.

Second part of this test?

• This test is perform for the posterolateral rotary instability.
• This test is perform in same way of the posteromedial rotary instability test technique .
• But different is that patient’s foot is sightly laterally rotated.
• It the tibia rotates posteriorly on to lateral side an excessive amount relatives to uninvolved leg , when the examiner pushes the tibia posterioly.
• Examiner is palpate to fibula while doing the movement to feel for excessive movement.

• This test is also perform in sitting position .
• Into sitting position flex to knee & sit to edge of the examining table.
• Then the examiner is pushes the knee posteriorly while holding the patient’s leg in medial rotation .
• After that watch the same excessive movement.

Result of this test?

First part of this test:

• This positive test indicates postero-medial rotary instability.

Second part of this test :

• This positive test is indicate to to posterolateral rotary instability.
• This test is positive only if the posterior cruciate ligament [ PCL ] & lateral collatral ligament is torn.

What is the structure injured when the test is positive?

In to first part of this test:

1. Posterior cruciate ligament
2. Medial collateral ligament
3. Posterior oblique ligament
4. Anterior cruciate ligament
5. Medial meniscus
6. Semimembranosus tendon
7. Posteromedial capsule