Apley's Compression Test: Differentiating Meniscus vs Ligament

Apley's Compression (or Grind) Test is a key orthopedic maneuver used to evaluate the knee. By using gravity and body weight in the prone position, it helps distinguish between meniscal tears and ligamentous sprains.

[Image of Apley's Compression Test knee]

1. Purpose

The primary purpose of Apley's Compression Test (also known as the Apley Grind Test) is to **test for** meniscal tears. It helps differentiate between meniscal pathology (pain with compression) and ligamentous pathology (pain with distraction).

2. How to Perform

1. The patient is positioned in prone (lying on their stomach).
2. The examiner flexes the patient's knee to 90 degrees.
3. The examiner applies a downward compressive force through the heel, pushing the tibia into the femur.
4. While maintaining compression, the examiner rotates the tibia internally and externally.
5. (Distraction Phase): The examiner then stabilizes the thigh, pulls the ankle upward (distraction), and rotates again to check for ligament injury.

3. Positive & Negative Sign

Positive Sign (Test is POSITIVE):
A positive test can indicate two different things depending on the maneuver:

• Pain or clicking during COMPRESSION: Indicates a Meniscal Tear.
• Pain during DISTRACTION (lifting up): Indicates a Ligamentous Injury (MCL/LCL) rather than a meniscus tear.

Negative Sign (Test is NEGATIVE):
A negative test is the absence of pain, clicking, or restriction during either compression or distraction.