Varus Stress Test (of the knee)

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Patient Position

  • Supine (or seated)

Procedure Steps

Supine testing

  • Drop the leg off the table and flex the knee to 30°.
  • Put fingers over the lateral joint line.
  • Grab the ankle/foot and apply a varus stress to the knee (using the medial knee against the outside of the table as a fulcrum and pushing the ankle lateral to medial).
  • Compare to the opposite, unaffected side.

Seated testing

  • Grasp the lateral ankle on the involved side of the body
  • Flex the knee to 20-30°
  • With the other hand, apply a medial-to-lateral varus force against the medial knee

Positive Sign / Significance

  • Significantly increased lateral joint space gapping = Lateral collateral ligament injury (grade 3 complete tear)
  • Pain over the lateral knee = Lateral collateral ligament sprain

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