Gravity Sign (Godfrey 90/90 Test) |
Examination type |
Ligamentous Stability Test
|
Patient & Body Segment Positioning |
The patient lies supine on a table with both the knee and hip of
the involved side flexed to 90 degrees.
|
Examiner Position |
The examiner should position themselves to the side of the
patient at eye level with the knee so that they are able to
observe if there is any posterior sag. The examiner holds
on to the patients toes with one hand. |
Tissues
Being Tested |
Posterior
Cruciate Ligament (PCL) |
Performing the Test |
The
examiner passively holds the patients toes and notes the
position of the patients tibia. The examiner should note
if the patient has any difference in the position the tibia is
sitting bilaterally. |
Positive Test |
The recognition of one tibia resting more inferiorly than the
contralateral side may indicate a posterior sag or instability.
This may be related to the posterior cruciate ligament. |
Interpretation |
A
positive test is present when there is a tear in the posterior
cruciate ligament causing posterior knee instability. |
Common errors in
performing exam |
The tibia must be maintained in neutral rotation and the test
must be done bilaterally. The test must be done passively
so the that muscle contractions of the leg do not pull the tibia
into a different position. |
Factors possibly
resulting in misinterpretation |
If
the tibia is not maintained in neutral rotation then a positive
finding may be a result of a capsular extensibility instead of a
posterior cruciate ligament tear. |
Related tests |
Posterior Sag Test (Gravity Drawer Test)
Reverse Pivot Shift (Jakob Test)
Posterior Drawer Test
Hughston Posteromedial Drawer Test
Hughston Posterolateral Drawer Test
Posterior Lachman’s Test
External Rotation Recurvatum Test |
References |
Brader, Holly, Isear, Jerome, Konin, Jeff,
& Wisten, Denise
(2002). Special Test for Orthopedic
Examination (2nd ed.).
Thorofare: SLACK Inc.
Magee, David (2002). Orthopedic
Physical
Assessment. Philadelphia:
Saunders.
Prentice, William E. (2003). Arnheim’s
Principles of Athletic
Training: A Competency-Based
Approach (11th ed.). St. Louis:
McGraw Hill.
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Links: |
http://www.physsportsmed.com/issues/1997/11nov/morgan.htm
http://www.emedicine.com/SPORTS/fulltopic/topic105.htm
http://www.maitrise-orthop.com/corpusmaitri/orthopaedic/mo56_knee_joint/knee_joint.shtml
http://www.athleticadvisor.com/Injuries/LE/Knee/pcl_injuries.htm
http://www.emedx.com/emedx/diagnosis_information/knee_disorders/posterior_cruciate_ligament_tear_outline.htm
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