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Author Topic: The Lachman test  (Read 2511 times)

Offline pdm1968

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The Lachman test
« on: April 15, 2008, 12:16:46 AM »
Had my knee fixed for a tear of meniscus in 06. Knee has never felt good even after that sugery. reinjured knee walking at work. Went to new surgeon. He told me I had a posible ACL TEar since I had a positvie Lachman test. Could this test in office be wrong ? It has been around 9 days since injury and I still get joint pain and swelling when I do alittle walking and it does po and crunch at times. The knee has only given out on me 1 time and I fell down luckily at home. But,every morning when I get up it hurts on the inital time I put pressure on my knee.

Offline Plumb

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Re: The Lachman test
« Reply #1 on: April 15, 2008, 02:02:09 AM »
If I am not mistaken it is a test that is done by you sitting on a table and the OS making a gumby out of you until you squeal or not squeal.

Followed by an MRI.. normally


http://en.wikipedia.org/wiki/Lachman_test

Offline tanyap

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Re: The Lachman test
« Reply #2 on: April 15, 2008, 03:38:15 PM »
go on YouTube and search for it - you will see both positive an dnegative versions. I have also heard that it can register a false positive if your ACL has healed onto your PCL.
Clinical exams can sometimes be skewed by the patients brain not letting (or letting) things happen without saying they hurt when they do or wincing cos they expect pain when they dont.
1986 - recurrent dislocations of right patella began
1988 - Modified Hauser Procedure
1991 - dislocations started again
2005 to 2007 - 150 dislocations in 2 years - OUCH!!!
June 2007 - new OS, new physio
Oct 2007 - VMO woke up
Mar 2008 - big quads, still dislocating
Apr 2008 - next OS app

Offline pdm1968

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Re: The Lachman test
« Reply #3 on: April 15, 2008, 06:35:42 PM »
Doctor already told me my right knee is loose when compared to the left knee. I had the test and he said I might have a torn acl . Now waiting on MRI

Offline tanyap

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Re: The Lachman test
« Reply #4 on: April 15, 2008, 08:04:34 PM »
MRI doesnt always shoe everything either but with a clinical exam, symptoms told to doc, and MRI you have a good chance of a correct diagnosis.
1986 - recurrent dislocations of right patella began
1988 - Modified Hauser Procedure
1991 - dislocations started again
2005 to 2007 - 150 dislocations in 2 years - OUCH!!!
June 2007 - new OS, new physio
Oct 2007 - VMO woke up
Mar 2008 - big quads, still dislocating
Apr 2008 - next OS app

Offline Kaputt_Knee

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Re: The Lachman test
« Reply #5 on: April 15, 2008, 09:55:56 PM »
The Lachmann Test shows laxity in the forwards backwards plane and is one of 3 tests for a torn ACL. The  others are the Drawer Test and the Pivot Shift which I believe is the clincher if the other two show laxity.

I have a positive Lachmanns in my right knee due to the implant being too long but the other two tests are still negative. As Tanya says an MRI is not foolproof - the only way they can be certain in the end is to go in and have a look see. Up to now none of my meniscus tears have shown up on MRI scans, although they have snipped and trimmed and repaired every time they have gone in there (Arthroscopy number 20 is coming up soon in that knee, only on number 5 on the other  ;) )

As someone else points out, the Lachmanns is not always a clear indicator because if you have been suffering pain, say from a torn meniscus (often occurs either at the same time or shortly afterwards), your body subconsciously protects the knee in a Lachmann Test.  So you can in fact have a torn ACL but the Lachmann Test is negative. Without a full diagonstic examination you cannot be sure.

Good Luck whatever happens.

Sue  ;) in Germany
1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline tanyap

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Re: The Lachman test
« Reply #6 on: April 16, 2008, 09:08:22 AM »
Sue - thats very interesting what you say about MRI and meniscus tear - my MRI shows a large meniscus tear but says it is 'not displaced', my new OS says it seems like my meniscus might be sliding about - so he is going in to look (he is also concerned that my ACL might be damaged but nothing shows on MRI and I have 'protected' myself on the clinical tests but showed apprehension on one of them so he stopped and said he will wait til Im under to redo it). Can meniscus tears hide in an MRI and not show what is really happening?

I was getting nervous about my scope - you have had 20 on one knee and 5 on another!!! So I must ask, in your expert opinion - do I have anything to worry about?
xx
Tanya
1986 - recurrent dislocations of right patella began
1988 - Modified Hauser Procedure
1991 - dislocations started again
2005 to 2007 - 150 dislocations in 2 years - OUCH!!!
June 2007 - new OS, new physio
Oct 2007 - VMO woke up
Mar 2008 - big quads, still dislocating
Apr 2008 - next OS app

Offline Kaputt_Knee

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Re: The Lachman test
« Reply #7 on: April 16, 2008, 09:31:09 AM »
Hi Tanya

it is normal to be nervous - for all my "experience" I am still nervous about the operation. Until they go in and actually see what the problem is they are never sure what is required. for example I went in for a replacement ACL and had a lateral release notch enlargement and debridement because once inside they saw that the problem was not a torn or non-functioning ACL - it just did not have room to function and the cartilaginous structures were so "hairy" they were giving false information on the MRI.

I give them Carte Blanc to do whatever is necessary because I trust them. I have never come out of surgery to a worsened situation, once or twice a changed one though  ???. I insist on having a CPM as soon as possible as this movement does help me not to build up scar tissue - the one time I did not have a CPM I had scar tissue issues and needed a MUA to excise it and get the knee going. since I've been in Germany I have noticed that the practice of leaving drains in the wound site for 24 to 48 hours has help reduce the length of time I have problems with post-op swelling. Coupled with the Lymph Drainage massage this seems to work for me.

Rehab after repairs are harder than rehabs after trims because of weight bearing issues. I had one trim here - day surgery, I went to my GP 48 hours later and he removed the drains. Three weeks later I was skiing and a month later I was back teaching skiing, 8 hours a day on skis working with all levels of clients. So it is not always the end of the world. I tend to take things as they come - if it delays the inevitable TKRs a bit longer then I'm OK with it.

hope this helps

Sue  ;) in Germany



1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline tanyap

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Re: The Lachman test
« Reply #8 on: April 16, 2008, 09:39:57 AM »
Thanks Sue - that helps a lot. My OS tells me he is really just going in to take a look and perhaps remove some bone spurs and check out whats happening inside. He said depending on what he finds he may just close me back up and schedule another surgery date for something bigger or he may be able to repair what he finds there and then. So I guess I wont know til after what has happened!! I do trust him and I will be telling him to do what he feels is necessary if he is doing anything at all. So I guess Ill just wait and see. Im much encouraged that you have survived so many scopes!!
Im most worried that he wont be able to figure out whats going on - I hope he can.
xx
1986 - recurrent dislocations of right patella began
1988 - Modified Hauser Procedure
1991 - dislocations started again
2005 to 2007 - 150 dislocations in 2 years - OUCH!!!
June 2007 - new OS, new physio
Oct 2007 - VMO woke up
Mar 2008 - big quads, still dislocating
Apr 2008 - next OS app

 















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