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Tibial External Rotation Test for Patellar Instability.

Bertram Zarins1

  • 1Massachusetts General Hospital, Boston, Massachusetts.

The Journal of Bone and Joint Surgery. American Volume
|February 5, 2022
PubMed
Summary
This summary is machine-generated.

The tibial external rotation test (TERT) is a new physical exam maneuver that can reproduce lateral patellar subluxation. This test helps diagnose patellar instability and guide surgical decisions.

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Biomechanics

Background:

  • Current physical examination tests lack the ability to dynamically assess patellar instability.
  • The influence of tibial rotation on patellar tracking is not well-reproduced in existing clinical assessments.

Purpose of the Study:

  • To introduce and describe the tibial external rotation test (TERT) as a novel physical examination method.
  • To demonstrate TERT's capability in reproducing lateral patellar subluxation and assessing patellar instability.

Main Methods:

  • The TERT involves externally rotating the tibia with the knee flexed at 90° and having the patient extend against resistance.
  • The test assesses changes in patellar stability with varying tibial rotation and an increased quadriceps angle (Q-angle).

Main Results:

  • The TERT successfully reproduced lateral patellar subluxation in patients with patellar instability.
  • The test demonstrated differential patellar stability based on tibial rotation, indicating its diagnostic utility.

Conclusions:

  • The tibial external rotation test (TERT) is a valuable provocative maneuver for diagnosing lateral patellar subluxation.
  • TERT can simulate the biomechanical effects of tibial tubercle medialization on patellar tracking.