Cooper D E
Sports Medicine Service, Hospital for Special Surgery, Cornell University Medical Center, New York City.
J Bone Joint Surg Am. 1991 Jan;73(1):30-6.
An apparently normal knee was examined in each of 100 subjects while they were under general or epidural anesthesia for an unrelated operation. The Lachman, anterior drawer, posterior drawer, and pivot-shift tests were negative in all knees. All knees were stable to varus and valgus stress at both 0 and 30 degrees of flexion. The external-rotation recurvatum test also was negative in all knees. A positive reversed pivot-shift sign was present in 35 per cent of the knees, suggesting that it may not signify abnormality, at least not without a negative test on the contralateral knee. The results of the posterolateral drawer test were variable, difficult to quantify, and did not always have a firm end-point. The amount of maximum external rotation of the tibia, measured from the reference line of the medial border of the foot, was extremely variable at both 30 and 90 degrees of flexion of the knee. External rotation, as determined by this reference, was slightly greater (averaging 9 degrees) at 90 than at 30 degrees of flexion. The normal range of maximum external rotation of the foot was 10 to 45 degrees at 30 degrees of flexion of the knee and 15 to 70 degrees at 90 degrees of flexion. The presence of a large angle of external rotation and a positive reversed pivot-shift sign correlated strongly with increased ligamentous laxity and mild varus alignment of the knee.
在100名因无关手术接受全身麻醉或硬膜外麻醉的受试者中，对每个看似正常的膝关节进行了检查。所有膝关节的拉赫曼试验、前抽屉试验、后抽屉试验和轴移试验均为阴性。所有膝关节在0度和30度屈曲时对内翻和外翻应力均稳定。所有膝关节的外旋反屈试验也为阴性。35%的膝关节出现阳性反向轴移征，这表明它可能并不意味着异常，至少在对侧膝关节试验为阴性时并非如此。后外侧抽屉试验的结果不一，难以量化，且并非总是有明确的终点。从足内侧缘参考线测量的胫骨最大外旋角度在膝关节30度和90度屈曲时变化极大。根据该参考确定，90度屈曲时的外旋略大于30度屈曲时（平均大9度）。膝关节30度屈曲时足最大外旋的正常范围为10至45度，90度屈曲时为15至70度。较大的外旋角度和阳性反向轴移征的存在与膝关节韧带松弛增加和轻度内翻排列密切相关。
