Apley’s Test for Meniscus Tears

According to research by Blyth et al. (2015), the statistical accuracy of this test was as low as 58%, which means that only 58% of the patients were correctly diagnosed by musculoskeletal clinicians. Later on, Hegedus et al. (2007) performed a systematic review with meta-analysis and found a sensitivity of 61% and a specificity of 70%. This means that this test’s accuracy to confirm or rule out meniscus tears is weak.

To perform this test, have your patient in prone position. Then, fixate the tested leg with your own leg and bring the knee into 90° of flexion. While you give distraction, perform lateral rotation of the tibial and medial rotation.

You are looking for excessive rotation compared to the other side or discomfort.

Then, repeat the same procedure, while you are giving compression. In this case, you are looking for decreased rotation or discomfort.

If rotation plus distraction is more painful or shows increased rotation relative to the normal side, the lesion is most probable ligamentous.
If rotation plus compression is more painful or shows decreased rotation relative to the normal side, the lesion is most probable meniscus damage.

Other common tests to assess for meniscus injuries are:

• McMurray Test
• Thessaly Test
• Joint Line Tenderness
• Ege’s Test
• Duck Walk Test
• Finochietto Test
• Bounce Home Test

Hegedus EJ, Cook C, Hasselblad V, Goode A, Mccrory DC. Physical examination tests for assessing a torn meniscus in the knee: a systematic review with meta-analysis. journal of orthopaedic & sports physical therapy. 2007 Sep;37(9):541-50.

Blyth, M., Anthony, I., Francq, B., Brooksbank, K., Downie, P., Powell, A., … & Norrie, J. (2015). Diagnostic accuracy of the Thessaly test, standardised clinical history and other clinical examination tests (Apley’s, McMurray’s and joint line tenderness) for meniscal tears in comparison with magnetic resonance imaging diagnosis. Health Technology Assessment.