The anterior drawer test is an indicator of the integrity of the anterior cruciate ligament.

Page updated June 2023 by Dr Sheila Strover (Clinical Editor)

anterior drawer test for acl insuffiency
By sitting on the patient's foot the limb is maintained with the knee at a right angle while the test is performed.

 

What is the examiner assessing?

The examiner is testing the displacement of the tibia in relation to the femur when the tibia is drawn forwards (anteriorly). If the cruciate ligament is torn or has come away from its bony attachment, this forwards displacement of the tibia will be greater than normal.

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How to perform the anterior drawer test

With the patient lying on his/her back, the leg is bent and the surgeon places the thumbs on either side of the patellar tendon, with the fingers behind the upper tibia and firmly pulls the tibia forward, assessing the forward movement and comparing it with the normal side. The forwards movement should be less than 6mm.

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Peer-reviewed papers

  • Quote:

    "The diagnosis of the ACL injury and the decision to reconstruct ACL could be reliably made with regards to the anterior drawer...The accuracy of these test increased considerably under anesthesia...The experience and precision of examiner will influence the end result of the test."

    Citation: Makhmalbaf H, Moradi A, Ganji S, Omidi-Kashani F. Accuracy of lachman and anterior drawer tests for anterior cruciate ligament injuries. Arch Bone Jt Surg. 2013 Dec;1(2):94-7. Epub 2013 Dec 15. PMID: 25207297; PMCID: PMC4151408.

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Synonyms: 
drawer test
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Dr Sheila Strover (Editor)
BSc (Hons), MB BCh, MBA

See biography...

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