PT Orthopedic Clinical Specialist (OCS) Clinical Practice Exam

The anterior drawer test evaluates the anterior cruciate ligament by assessing how far the tibia can move forward relative to the femur when the knee is flexed. The ACL normally limits this forward translation, so a torn or lax ACL allows increased anterior tibial movement and often a softer or absent end-feel. To perform, have the patient lie supine with the knee bent to about 90 degrees and the foot stabilized, then gently pull the tibia forward. A positive finding is greater anterior tibial excursion compared with the other knee, indicating ACL deficiency. This distinguishes ACL injury from issues involving the posterior cruciate ligament (which would show increased posterior translation) or the collateral ligaments (which are tested with varus/valgus stress). Be mindful that pain or hamstring guarding can affect the result.