Moving Patellar Apprehension Test

Original Editor - David Adamson

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Purpose

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

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 examiners thumb.  The examiner then moves the knee from full extesnion 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 maneuver.  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 examiners 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 on the provocation test (part 1),  and alleviaiton of these symptoms in part 2 of the test.  

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 anesthesia. 

The test was found to have the following:

Sensitivity:  100%                                Positive predictive value:  89.2%

Specificity: 88.4%                                Negative predictive value:  100%

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