Lachman test: Knee examination clinical test to examine knee stability in particular the stability of the anterior cruciate ligament (ACL).
History and Controversy
1875 – Georges C Noulis first described the test his thesis
…fixes the thigh with one hand; with the other hand hold the leg just below the knee with the thumb in front and the rest of the fingers behind; then try to push the tibia forward and backward … When only the ACL is broken, forward movement is seen when the knee is slightly flexed…
1960 – Sterling Ritchey, of the Walter Reed Army Hospital in Washington DC, rediscovered the test.
1976 – Joseph Torg eponymised and popularized the described ACL examination as the ‘Lachman Test‘ as a means of preoperative assessment of ACL rupture and postoperatively as an evaluation surgical success.
My first exposure to this observation occurred as a resident when presenting a patient to the chief on rounds. Upon turning back the covers, he simply looked at the patient’s knee and stated, “He has a torn anterior cruciate.” The patient’s anterior drawer test was unremarkable; however, surgical findings indicated a complete tear of the anterior cruciate ligament. Thus, a clinical “pearl” had been simply passed on, as Dr. Lachman had done hundreds if not thousands of times before to his students and residents. – Joseph S. Torg, MD (writing about his boss and mentor Dr J.W. Lachman)
- Schindler OS. Surgery for anterior cruciate ligament deficiency: a historical perspective. Knee Surg Sports Traumatol Arthrosc. 2012 Jan;20(1):5-47. [PMID 22105976]
- Noulis G. Entorse du genou. Thé No. 142. Fac Med, Paris 1875.[Reference]
- Ritchey SJ. Ligamentous disruption of the knee. A review with analysis of 28 cases. U S Armed Forces Med J. 1960 Feb;11:167-76. [PMID 14437598]
- Torg JS, Conrad W, Kalen V. Clinical diagnosis of anterior cruciate ligament instability in the athlete. Am J Sports Med. 1976 Mar-Apr;4(2):84-93. [PMID 961972] [Full text]
- Colombet Ph, Allard M, Bousquet V, Delavigne C, Flur PH. The history of ACL surgery. Maîtrise Orthopédique. N°87 – October 1999 [Full Text]