Execution
- 1Position the patient supine.
- 2Apply varus stress with the knee in full extension.
- 3Repeat varus stress with the knee flexed approximately 20 to 30 degrees.
- 4Stabilize the medial femur and applies an adducting force to the distal tibia.
- 5Compare lateral joint opening, pain, and end feel with the opposite knee.
Positive outcome
Lateral joint opening, pain, or a soft end feel at 30 degrees is positive for LCL injury. Varus laxity in full extension suggests combined posterolateral, capsular, or cruciate involvement. Neurovascular status should be checked in severe lateral injuries.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| LaPrade et al. (2008) | NA | NA | NA | NA | NA |
CommentVarus stress is clinically important for LCL and posterolateral corner assessment, but high-quality standalone Sn/Sp data are limited. As with valgus testing, the 0-degree versus 30-degree distinction changes the interpretation. Combine it with dial and reverse pivot-shift tests when PLC injury is suspected.
Low Clinical Value