Manual laxity tests for anterior cruciate ligament injuries

The manual laxity examination is the primary means by which clinicians evaluate ACL injuries. This paper reviews the literature and identifies the following ACL laxity tests: anterior drawer test, Lachman test. MacIntosh test, jerk test, flexion rotation drawer test, Slocum test, and the Losee test. Test technique, grading, limitations, and reliability are discussed for each test. General limitations of manual laxity tests are also presented. A review of ACL anatomy and the biomechanics of the pivot shift sign are provided to facilitate an understanding of the underlying principles of ACL laxity tests. J Orthop Sports Phys Ther 1990;11(10):474-481.