Posterior Drawer Test: How to Check for PCL Injury

The Posterior Drawer Test is a standard orthopedic test used to assess the integrity of the Posterior Cruciate Ligament (PCL). It involves pushing the shin bone backwards to check for excessive movement.

1. Purpose

The primary purpose of the Posterior Drawer Test is to **test for** the integrity of the Posterior Cruciate Ligament (PCL). It assesses the amount of posterior (backward) movement of the tibia relative to the femur.

2. How to Perform

1. The patient is positioned in supine (lying on their back).
2. The patient's hip is flexed to 45 degrees and the knee is flexed to 90 degrees.
3. The examiner sits gently on the patient's foot to stabilize it in neutral rotation.
4. The examiner places both hands on the proximal tibia, with thumbs on the tibial tuberosity.
5. The examiner applies a firm, posterior (backward) force to the tibia.

3. Positive & Negative Sign

Positive Sign (Test is POSITIVE):
A positive test (indicating a PCL tear) is:

• Excessive posterior translation of the tibia compared to the uninjured side.
• A "soft" or "mushy" end-feel, indicating the ligament is not intact.

Negative Sign (Test is NEGATIVE):
A negative test is a firm end-feel with minimal posterior movement.