- The patient should lie completely flat with extended hips and knees.
- The ‘neutral position’ of the knee joint is where the hip, knee and ankle lie on a single line when viewed laterally [Figure 56].
Figure 56
Procedure
Inspect the movements and assess:
- Course of the movement.
- Maximum range of motion.
- Occurrence of pain.
- Occurrence of crepitations.
- Lateral displacement of the patella (a dysplastic patella can become displaced during flexion).
Assess this by asking the patient to perform the following movements:
- Flexion – Bring the heel against the buttocks if possible [Figure 57].
- Extension – ‘Press’ the hollow of the knee downwards into the examination table. The movement should start with the knee in a position of maximum flexion [Figure 58].
- The exorotation and endorotation of the knee at 90° flexion, is almost never disturbed in active movement and does not need to be actively examined.
Figure 57
Figure 58