In the Anterior Drawer Test, how is the knee positioned and what does the examiner do?

• A. Knee Flexed to 90 Degrees; Examiner Pulls Tibia Anteriorly
• B. Knee Flexed to 45 Degrees; Examiner Pushes Tibia Posteriorly
• C. Knee Extended; Examiner Applies Varus Stress
• D. Knee Flexed to 90 Degrees; Examiner Pushes Tibia Posteriorly

Answer: (A)

This test checks ACL integrity by examining how far the tibia can translate forward with the knee bent to 90 degrees. In this position the ACL normally restrains anterior movement, and the hamstrings don’t prevent forward glide as effectively, so a forward pull on the tibia isolates the ACL’s function. The examiner stabilizes the foot and pulls the tibia anteriorly, feeling for excessive translation or a soft end-feel compared with the other knee. A positive result suggests ACL disruption. Pushing the tibia backward, extending the knee with a varus stress, or using a 45-degree flexion are not how this test is performed; they assess other ligaments or perform different stress tests.