Noyes Flexion-Rotation Drawer Test Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Diagnosing Anterior Cruciate Ligament (ACL) tears and ALRI.
How to Perform
- Position: Patient supine. Examiner holds the leg in 20-30° flexion.
- Action: The tibia is held in neutral and then allowed to drop posteriorly (if gravity allows) or manually reduced from a subluxated position by flexing the knee.
Interpretation of Results
- Positive Test: The tibia reduces (moves backward) and the femur rotates externally as the knee is flexed, indicating ACL insufficiency.
Clinical Context & Limitations
The Noyes Flexion-Rotation Drawer Test should be considered as one component of a comprehensive musculoskeletal assessment. No single special test has perfect diagnostic accuracy; thus, clinical decision-making should integrate test results with patient-reported symptoms, mechanism of injury, functional impairment, and relevant imaging.
Clinicians should be aware of potential false-positive results in patients with pain sensitisation, muscle guarding, or poor relaxation. For the Knee region, combining the Noyes Flexion-Rotation Drawer Test with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment.
