The moving patellar apprehension test for lateral patellar instability

Christopher S. Ahmad, Moira McCarthy, Jaime A. Gomez, Beth E. Shubin Stein

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Background: Physical examination maneuvers for patellar instability are often inaccurate. Hypothesis: The "moving patellar apprehension test" is a sensitive and specific physical examination technique for the diagnosis of patellar instability. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: The moving patellar apprehension test was performed in an office setting preoperatively and compared with the ability to dislocate the patella when examined under anesthesia in 51 patients. The examination begins with the knee held in full extension and the patella is manually translated laterally with the thumb. The knee is then flexed to 90° and then brought back to full extension while the lateral force on the patella is maintained. For the second half of the test, the knee is started in full extension, brought to 90° of flexion, and then back to full extension while the index finger is used to translate the patella medially. For a positive test in part 1, the patient orally expresses apprehension and may activate his or her quadriceps in response to apprehension. In part 2, the patient experiences no apprehension and allows free flexion and extension of the knee. Results: When compared with the ability to dislocate the patella under anesthesia, the moving patellar apprehension test was found to have a sensitivity of 100%, a specificity of 88.4%, a positive predictive value of 89.2%, a negative predictive value of 100%, and an accuracy of 94.1%. Conclusion: The moving patellar apprehension test is an accurate physical examination technique that, when performed and interpreted correctly, is highly sensitive and specific for patellar instability.

Original languageEnglish (US)
Pages (from-to)791-796
Number of pages6
JournalAmerican Journal of Sports Medicine
Volume37
Issue number4
DOIs
StatePublished - Apr 2009
Externally publishedYes

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Patella
Knee
Physical Examination
Anesthesia
Thumb
Fingers
Cohort Studies

Keywords

  • Medial patellofemoral ligament
  • Patellar instability
  • Physical examination

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Medicine(all)

Cite this

The moving patellar apprehension test for lateral patellar instability. / Ahmad, Christopher S.; McCarthy, Moira; Gomez, Jaime A.; Shubin Stein, Beth E.

In: American Journal of Sports Medicine, Vol. 37, No. 4, 04.2009, p. 791-796.

Research output: Contribution to journalArticle

Ahmad, Christopher S. ; McCarthy, Moira ; Gomez, Jaime A. ; Shubin Stein, Beth E. / The moving patellar apprehension test for lateral patellar instability. In: American Journal of Sports Medicine. 2009 ; Vol. 37, No. 4. pp. 791-796.
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