The Apley grind test or Apley test is used to evaluate individuals for problems in the

meniscus Meniscus may refer to: * Meniscus (anatomy), crescent-shaped fibrocartilaginous structure that partly divides a joint cavity * Meniscus (liquid), a curve in the upper surface of liquid contained in an object *Meniscus (optics) A lens is a ...

of the

knee In humans and other primates, the knee joins the thigh with the human leg, leg and consists of two joints: one between the femur and tibia (tibiofemoral joint), and one between the femur and patella (patellofemoral joint). It is the largest join ...

. The Apley grind test has a reported sensitivity of 97% and a specificity of 87%.

Description

In order to perform the test, the patient lies prone (face-down) on an examination table and flexes their knee to a ninety degree angle. The examiner then places his or her own knee across the posterior aspect of the patient's thigh. The

tibia The tibia (; ), also known as the shinbone or shankbone, is the larger, stronger, and anterior (frontal) of the two bones in the leg below the knee in vertebrates (the other being the fibula, behind and to the outside of the tibia); it connects ...

is then compressed onto the knee joint while being externally rotated. If this maneuver produces pain, this constitutes a "positive Apley test" and damage to the meniscus is likely. Lateral rotation tests for medial implications (meniscal during compression and ligamentous when distracting the tibia) and medial rotation tests for lateral implications again (meniscal during compression and ligamentous when distracting the tibia). Greater than 90 degrees of knee flexion will impinge more of the posterior horn, 90 degrees of knee flexion the medial meniscus and the closer to knee extension the further the anterior horn is being tested (< 90 degrees of knee flexion).

History and etymology

The Apley test is named for

Alan Graham Apley Alan Graham Apley FRCS (10 November 1914, London – 20 December 1996) was a British orthopaedic surgeon and educator known for his textbook, ''Apley's System of Orthopaedics and Fractures'', and for the Apley grind test in meniscal injury. B ...

Apley AG. ''The diagnosis of meniscus injuries.'' J Bone Joint Surg 1947; 29:78-84 (1914–1996), a British

orthopedic surgeon Orthopedic surgery or orthopedics ( alternatively spelt orthopaedics), is the branch of surgery concerned with conditions involving the musculoskeletal system. Orthopedic surgeons use both surgical and nonsurgical means to treat musculoskeleta ...

References

{{Orthopedic examination , state=autocollapse Examination of the knee