What is Patellar Apprehension Test?
Patellar Apprehension Test (or Fairbank Apprehension Test) is used to test whether the patella is likely to dislocate laterally (Patellar Instability).
How it’s Performed?
- The patient is supine with the knee extended and the thigh muscles relaxed.
- The examiner attempts to simulate a dislocation (in a manner similar to the Apprehension Test in anterior instability of the shoulder) by placing both thumbs on the medial aspect of the knee and pressing the patella laterally.
- The patient is then asked to ex the knee.
- Examiner observes patient’s reaction.
The test is conducted slowly enough so that it can be terminated once the anticipated response is elicited but before causing the patient undue discomfort.
What does a positive Patellar Apprehension Test mean?
Where a patellar dislocation has occurred, the patient will report severe pain and will be apprehensive of another dislocation in extension or, at the latest, in flexion.
This apprehension manifests itself with behavior ranging from verbal expressions of anxiety to an involuntary quadriceps contraction that prevents further knee flexion.
Sensitivity & Specificity
A Cohort study by Christopher S Ahmad 1 found that the patellar Apprehension Test is an accurate physical examination in assessing Patellar Instability, the Sensitivity & Specificity of this test was:
- Sensitivity: 100 %
- Specificity: 88 %
- Ahmad CS, McCarthy M, Gomez JA, Shubin Stein BE. The moving patellar Apprehension Test for lateral Patellar Instability. Am J Sports Med. 2009 Apr;37(4):791-6. doi: 10.1177/0363546508328113. Epub 2009 Feb 3. PMID: 19193601.
- Clinical Tests for the Musculoskeletal System 3rd Edition.
- Dutton’s Orthopaedic Examination, Evaluation, And Intervention 3rd Edition.
- Sarvdeep S. Dhatt, Sharad Prabhakar – Handbook of Clinical Examination in Orthopedics.
- Campbel’s Operative Orthopaedics 12th edition Book.
- Millers Review of Orthopaedics -7th Edition Book.
- Ronald McRae – Clinical Orthopaedic Examination 6th Edition Book
- Netter’s Orthopaedic Clinical Examination An Evidence-Based Approach 3rd Edition Book
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