Execution
- 1Position the patient supine or sitting with the knee extended.
- 2Palpate the patellar tendon, especially the inferior pole region, to identify tenderness.
- 3Then flex the knee to approximately 90 degrees.
- 4Palpate the same tendon region again.
- 5Compare whether tenderness decreases or disappears in knee flexion.
Positive outcome
The test is positive when patellar tendon tenderness present in knee extension decreases or disappears with the knee flexed to 90 degrees. This knee-region Royal London test is framed for patellar tendinopathy, not Achilles tendinopathy. Local tendon pain is required.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Maffulli et al. (2017) | NA | 88 | 98 | 44 | 0.12 |
CommentThe Royal London Hospital Test was adapted from Achilles tendinopathy assessment and studied for patellar tendinopathy in a small sample. The reported LR+ is strong, but the sample size makes exact estimates unstable. It is more specific than simple palpation when the extension-to-flexion change is clear.
High Clinical Value