英文原文：
Dr. Ebraheim’s educational animated video describes test for evaluation of knee injuries and all the maneuvers you need to know to preform an excellent knee examination.
McMurray’s test is a knee examination test that elicits pain or a painful click as the knee is brought from flexion to extension with either internal or external rotation. The McMurray’s test uses the tibia to trap the meniscus between the femoral condyle and the tibia.
When performing the McMurray’s test, the patient should be lying supine with the knee flexed. The examiner grasps the patient’s heel with one hand and places the other hand over the knee joint. To test the medial meniscus, the knee is fully flexed and the examiner then passively externally rotates the tibia and places a valgus force. The knee is then extended in order to test the medial meniscus. to tests the lateral meniscus, the examiner passively internally rotates the tibia and places a varus force. The knee is then extended in order to test the lateral meniscus. A positive test is indicated by pain, clicking or popping within the joint and may signal a tear of either the medial or lateral meniscus when the knee is brought from flexion to extension.
Lachman’s test is the most sensitive and best test for examining an ACL injury. The patient should be lying supine and completely relaxed. Make sure that the patient’s hip, quadriceps and hamstring muscles are all relaxed. Bend the knee to about 20-30°. Stabilize the femur with one hand and with the other hand, pull the tibia anteriorly and posteriorly against the femur. With an intact ACL as the tibia is pulled forward the examiner should feel an endpoint. If the ACL is ruptured, the ACL will be lax and the examination will feel softer with no endpoint. The tibia can be pulled forward more than normal (anterior translation).
Both the Lachman’s test and the Pivot shift test are associated with 20-30°s of knee flexion. The Lachman’s test starts at 20-30 ° of flexion. With the Pivot shift test you feel the clunk at 20-30°s of flexion. 20-30°s of flexion is important for examination of the ACL (remember that). The patient should be lying supine. Make sure the patient is totally relaxed. With pivot shift, the knee is in the subluxed position and the knee is in full extension. The pivot shift starts with extension of the knee and you can feel the clunk at 20-30° of flexion. Hold the knee in full extension then add valgus force plus internal rotation of the tibia to increase the rotational instability of the knee. Then take the knee into flexion. A palpable clunk is very specific of an ACL tear. the iliotibial band will reduce the tibia and create the clunk on the outside of the knee. Always compare with the other side.
The reverse pivot shift test helps to diagnose acute or chronic posterolateral instability of the knee. A significantly positive reverse pivot shift test suggests that the PCL, the LCL, the arcuate complex and the popliteofibular ligament are all torn.
The reverse pivot shift test begins with the patient supine with the knee in 90° flexion. Valgus stress is then applied to the knee with an external rotation force. Bring the knee from 90°s of flexion to full extension. The tibia reduces from a posterior subluxed position at about 20°s of flexion. A shift and reduction of the lateral tibial plateau can be felt as it moves anteriorly from a posteriorly subluxed position. A clunk occurs as the knee is extended. This is called reverse pivot shift because shift of the lateral tibial plateau occurs in the opposite direction of the true pivot shift (Seen in ACL tears). If the tibia is posterolaterally subluxed, the iliotibial band will reduce the knee as the IT band transitions form a flexor to extensor of the knee. It is very important to compare this tests to the contralateral knee. Pivot shift = ACL tear
The test is done with the patient in supine position and the knee is flexed to 90°. The examiner stabilizes the foot. Next the examiner pushes backward on the tibia, looking for the tibia to sag posteriorly. Observer the sag that develops due to tear of the posterior cruciate ligament (PCL). The amount of translation in relationship to the femur is observed. The test is considered positive if excessive posterior translation of the tibia is demonstrated.
中文翻译参考：
Ebraheim博士的教育动画视频描述了评估膝盖损伤的测试，以及进行出色的膝盖检查所需的所有动作。
McMurray的测试是一种膝盖检查测试，当膝盖从屈曲转为伸展时，无论是内部旋转还是外部旋转，都会引起疼痛或疼痛的咔嗒声。麦克默里试验使用胫骨将半月板夹在股骨髁和胫骨之间。
进行麦克默里试验时，患者应仰卧，膝盖弯曲。检查者用一只手抓住患者的脚跟，另一只手放在膝关节上。为了测试内侧半月板，膝盖完全弯曲，然后检查者被动地向外旋转胫骨并施加外翻力。然后伸展膝盖以测试内侧半月板。为了测试外侧半月板，检查者被动地旋转胫骨并施加内翻力。然后伸展膝盖以测试外侧半月板。阳性测试表现为关节内疼痛、咔嗒声或爆裂声，当膝盖从屈曲变为伸展时，可能表示内侧或外侧半月板撕裂。
Lachman’s测试是检查前交叉韧带损伤最敏感、最好的试验。患者应仰卧，完全放松。确保患者的臀部、股四头肌和腿筋肌肉都放松。弯曲膝盖至约20-30°。一只手稳定股骨，另一只手前后拉动胫骨抵住股骨。胫骨前移时ACL完整，检查者应感觉到终点。如果ACL破裂，ACL会松弛，检查会感觉更柔软，没有终点。胫骨可以比正常情况更向前拉动（向前平移）。
Lachman’s测试和枢轴移位试验均与膝关节屈曲20-30°有关。Lachman’s测试从屈曲20-30°开始。通过枢轴移位测试，您可以在20-30°屈曲时感觉到沉重的声音。20-30°的屈曲对于检查前交叉韧带非常重要（请记住）。患者应仰卧。确保患者完全放松。随着枢轴移动，膝盖处于半脱位，膝盖完全伸展。枢轴移动从膝盖伸展开始，你可以在20-30°屈曲时感觉到沉重的声音。保持膝盖完全伸展，然后增加外翻力和胫骨内旋，以增加膝盖的旋转不稳定性。然后膝盖弯曲。明显的咯咯声是前交叉韧带撕裂的特殊表现。髂胫束将减少胫骨，并在膝盖外侧产生隆隆声。总是与另一边比较。
反向枢轴移位试验有助于诊断急性或慢性膝关节后外侧不稳定。一项显著阳性的反向枢轴移位测试表明，PCL、LCL、弓形复合体和腘腓韧带均撕裂。
反向枢轴移位测试从患者仰卧开始，膝盖呈90°屈曲。然后，外翻应力通过外部旋转力施加到膝盖上。将膝盖从90°屈曲到完全伸展。胫骨在屈曲约20°s时从后半脱位减少。当外侧胫骨平台从后半脱位向前移动时，可以感觉到胫骨平台的移位和缩小。膝盖伸展时会发出咯咯声。这被称为反向枢轴移位，因为外侧胫骨平台的移位发生在真实枢轴移位的相反方向（见ACL撕裂）。如果胫骨后外侧半脱位，随着IT带从膝屈肌过渡到伸肌，髂胫带将减少膝关节。将此测试与对侧膝盖进行比较非常重要。枢轴移位=ACL撕裂
患者处于仰卧位，膝盖弯曲至90°。考官稳定住脚。接下来，检查者向后推胫骨，观察胫骨是否向后凹陷。观察后交叉韧带（PCL）撕裂引起的下垂。观察与股骨相关的平移量。如果证实胫骨过度后移，则该测试被视为阳性。