In the Anterior Drawer test for ACL integrity, which technique and finding define a positive result?

• A. Knee flexed to 0-30 degrees; stabilize the foot and translate the tibia anterior; a positive result is displacement greater than 5 mm with a soft end-feel.
• B. Supine, with foot stabilized on table and knee flexed to 80-90 degrees; translate proximal tibia forward; positive when displacement exceeds 5 mm.
• C. The knee is extended and the examiner taps the tibia to test ligament laxity.
• D. The knee is flexed and rotated to test meniscal pathology.

Answer: (B)

Assessing anterior tibial translation to evaluate ACL integrity. To perform it, have the patient lie supine with the knee flexed to about 80–90 degrees, stabilize the foot to prevent ankle movement, and translate the proximal tibia forward relative to the femur. A positive result is when the tibia moves forward more than about 5 mm compared with the opposite knee, indicating ACL laxity or rupture. This specific knee angle stresses the ACL while reducing hamstring guarding, so excessive anterior translation in this position signifies injury. Other described approaches refer to different tests or positions (such as Lachman at 0–30 degrees for a different assessment, or tests targeting meniscal pathology), which is why this technique and finding are the correct match.