Moving Patellar Apprehension Test

Original Editor - David Adamson

Top Contributors - David Adamson, Dan Rhon, Daniele Barilla, Claire Knott and Wanda van Niekerk  

Purpose

This is a test that is designed for the clinical identification of lateral patellar instability. [1]

Technique

The moving patellar apprehension test is performed in two parts.  Part 1 is a provocation oriented test.  The examiner places the knee to be examined into full extension.  A lateral force is applied to the patella with the examiner's thumb.  The examiner then moves the knee from full extension to 90 deg of flexion and then returning to full extension while maintaining the laterally applied force on the patella.  

The second aspect of the test (Part 2) consists of a symptom alleviation manoeuver.  The examiner repeats the part 1 of the test with a medially applied force on the patella.  The examiner places the knee to be examined into full extension. A medial force is applied to the patella with the examiner's index finger.  The examiner then moves the knee from full extension to 90 deg of flexion and then returning to full extension while maintaining the medially applied force on the patella.  

A positive test consists of orally expressed apprehension or an apprehensive quadriceps recruitment on the provocation test (part 1), and alleviation of these symptoms with normal ROM within the test ROM in part 2 of the test.  

[2]

Evidence

The authors of the test compared the findings of the moving patellar apprehension test with the stability of the patella to laterally directed force under anaesthesia. 

The test was found to have the following:

Sensitivity:  100% Positive predictive value:  89.2%
Specificity: 88.4% Negative predictive value:  100%

Resources

  Moving Patellar Apprehension Test

References

  1. Ahmad CS, McCarthy M, Gomez JA, Shubin Stein BE. The moving patellar apprehension test for lateral patellar instability. Am J Sports Med. 2009 Apr;37(4):791-6. Epub 2009 Feb 3.
  2. Clinically Relevant Technologies, http://www.youtube.com/watch?v=4TJaS4IAUVk ;accessed May 2011