Question

What would be the most reliable test for an acutely injured knee of a 27-year-old athlete?

• A. Anterior drawer test
• B. Posterior drawer test
• C. Lachman test
• D. Steinmann test

Hint:

In an acute knee injury, swelling and hamstring spasm block full flexion, so the low-flexion Lachman test outperforms the anterior drawer test.

Answer 1

The Correct Option is C

Step 1: Understand what is being tested.
An acutely injured knee in a young athlete is a classic setup for an anterior cruciate ligament (ACL) tear. The question asks which clinical test is most reliable right after the injury, not weeks later.

Step 2: Compare the anterior drawer test and the Lachman test.
The anterior drawer test is done with the knee bent to 90 degrees, and the examiner pulls the tibia forward to check for excess movement. The Lachman test checks the same forward movement of the tibia on the femur, but with the knee bent only 20 to 30 degrees.

Step 3: Explain why the acute setting changes the answer.
Right after an ACL injury, the knee is swollen (haemarthrosis) and the hamstring muscles often go into protective spasm. Bending the knee to a full 90 degrees for the anterior drawer test is painful and often impossible in this state, and hamstring spasm can hide the forward slide of the tibia, giving a false negative result. The Lachman test needs only a small bend of the knee, so swelling and spasm interfere with it much less, which makes it more sensitive and more reliable in a fresh, acute injury.

Step 4: Rule out the other options.
The posterior drawer test checks the posterior cruciate ligament, not the ACL, so it does not fit a typical acute ACL injury picture. The Steinmann test is used for meniscal tears, not ligament injuries, so it is not the right test here either.

Step 5: Note on the original answer key.
The original 2002 answer key for this paper marks the anterior drawer test as correct. Current orthopedic teaching, and most current exams, instead favor the Lachman test as the most sensitive and reliable test for an acute ACL injury, precisely because it does not need the painful full 90 degree flexion that the drawer test needs. This solution follows the current, better supported answer, and this override is flagged here for review.

Step 6: Final answer.
\[ \boxed{\text{Lachman test}} \]