Apley grind test

The Apley grind test or Apley test is used to evaluate individuals for problems in the meniscus of the knee.[1]

In order to perform the test, the patient lays prone (face-down) on an examination table and flexes their knee to a ninety degree angle. The examiner then places his or her own knee across the posterior aspect of the patient's thigh. The tibia is then compressed onto the knee joint while being externally rotated. If this maneuver produces pain, this constitutes a "positive Apley test" and damage to the meniscus is likely. Lateral rotation tests for medial implications (meniscal during compression and ligamentous when distracting the tibia), Medial rotation tests for lateral implications again (meniscal during compression and ligamentous when distracting the tibia). Greater than 90 degrees of knee flexion will impinge more of the posterior horn, 90 degrees of knee flexion the medial meniscus and the closer to knee extension the further the anterior horn is being tested (< 90 degrees of knee flexion). Sensitivity 97% & Specificity 87%.

The Apley test is named for Alan Graham Apley[2] (1914–1996), a British orthopedic surgeon.

References

  1. Solomon, D. H.; Simel, D. L.; Bates, D. W.; Katz, J. N.; Schaffer, J. L. (2001). "The rational clinical examination. Does this patient have a torn meniscus or ligament of the knee? Value of the physical examination". JAMA: the Journal of the American Medical Association 286 (13): 1610–1620. doi:10.1001/jama.286.13.1610. PMID 11585485.
  2. Apley AG. The diagnosis of meniscus injuries. J Bone Joint Surg 1947; 29:78-84