Martens’ Test | Anterior Cruciate Ligament Tear

Martens et al. (1981) described a test for anterior subluxation of the tibia that according to his article has the advantage of obviating apprehension and muscle spasms during test execution avoiding false negative results.

However, the test has not been formally assessed on its diagnostic accuracy against a reference standard so the clinical value remains questionable.

To conduct the test, the patient lies in supine position. The patient’s lower leg is braced between your arm and body. Place one hand behind the tibia proximally and the other hand on the femur distally. The first step is the Lachman maneuver where the tibia is pulled anteriorly and the femur posteriorly.

Here, straight anterior subluxation of the tibia will be apparent in an ACL-deficient knee.

In the second step, the examiner adds a valgus torque through the elbow at the patient’s ankle as well as internal rotation of the tibia.

A positive test is indicated by a sudden snap of varying degrees that is felt or seen as the tibia subluxes anteriorly.

21 OF THE MOST USEFUL ORTHOPAEDIC TESTS IN CLINICAL PRACTICE

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Other common tests to assess for an ACL tear are:

• Anterior Drawer Test
• Lachman Test
• Lateral Pivot-Shift Test

References

Martens, M. A., & Mulier, J. C. (1981). Anterior subluxation of the lateral tibial plateau. A new clinical test and the morbidity of this type of knee instability. Archives of Orthopaedic and Traumatic surgery. Archiv fur Orthopadische und Unfall-chirurgie, 98(2), 109-111.