Lachman Test Procedure and Interpretation

Test Performance and Reliability

The Lachman test is performed with the patient supine, the knee flexed to 20-30 degrees, the examiner stabilizing the distal femur with one hand while applying an anteriorly directed force to the proximal tibia with the other hand, assessing for anterior tibial translation and end-feel quality compared to the contralateral knee, as recommended by the American Academy of Orthopaedic Surgeons 1, 2, 3
The Lachman test is the most reliable clinical test for ACL rupture, more sensitive than the anterior drawer test, according to the American Academy of Orthopaedic Surgeons and the British Journal of Sports Medicine 1, 2, 3

The American Orthopaedic Society for Sports Medicine recommends using the Lachman test alongside pivot shift and anterior drawer tests as part of a clinical examination battery for optimal diagnostic accuracy in patients with suspected ACL injuries 4, 5
The International Knee Documentation Committee suggests incorporating patient-reported measures, such as IKDC subjective scores and KOOS, into the diagnostic process for comprehensive ACL assessment in patients with knee injuries 4, 5