How to Perform an Anterior Drawer Test of the Knee

The anterior drawer sign is a physical finding that is part of a knee examination. It tests for the integrity of the anterior cruciate ligament, one of the most important ligaments stabilizing the knee. It is an examination that is often seen performed on football players following a knee injury.

Instructions

Difficulty: Moderately Easy

1. Read about the anatomy involved in the anterior drawer sign. There are two cruciate ligaments in the knee, the anterior (in the front) and the posterior (in the back). These ligaments are called cruciate ligaments because they cross the joint to hold the joint steady from the front and the back.
2. Position the patient on his back.
3. Flex the patient's leg at the hip so that the lower leg is roughly at a 90 degree angle relative to the upper leg,
4. Stabilize the patient's leg by sitting on her feet.
5. Grab the upper portion of the calf with both hands. Apply gentle pressure, pulling forward, testing how forward the lower leg can move below the upper leg.
6. Repeat the maneuver on the opposite, uninjured side to have a basis for comparison. Laxity of the injured leg with the lower leg moving forward indicates a tear to the anterior cruciate ligament.

Tips & Warnings

• A positive drawer sign is of concern but a negative sign does not necessarily mean the cruciate ligament is intact. Muscular guarding can obscure an injury.