Execution
- 1Position the patient supine with the hip flexed to 45 degrees and the knee flexed to 90 degrees.
- 2Stabilize the patient's foot on the table.
- 3Check first for posterior sag of the tibia.
- 4Grasp the proximal tibia with both hands and push the tibia posteriorly.
- 5Compare posterior translation and end feel with the opposite knee.
Positive outcome
Excessive posterior tibial translation or loss of normal anterior tibial step-off is positive for PCL injury. Translation grading helps estimate severity. Posterolateral corner injury should be considered when posterior drawer is combined with rotational laxity.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Rubinstein et al. (1994) | NA | 90 | 99 | 90 | 0.10 |
CommentPosterior drawer is the key manual test for PCL integrity and is more useful than many secondary PCL signs. Magee notes that suspected PCL injury should trigger a full ligament exam, especially posterolateral corner assessment. Diagnostic values look strong in classic cohorts but may vary with partial tears.
High Clinical Value