Name:
Lelli's Test for ACL
Description:
Lelli's Test for ACL
Thumbnail URL:
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Duration:
T00H04M04S
Embed URL:
https://stream.cadmore.media/player/40223daf-30ba-412e-a21e-1406a5c927c0
Content URL:
https://cadmoreoriginalmedia.blob.core.windows.net/40223daf-30ba-412e-a21e-1406a5c927c0/Lelli%27s Test for ACL.mp4?sv=2019-02-02&sr=c&sig=7VZoS853Qp%2FcoziiAtWOcRV8e%2BNeh%2BicllRXkWHzQGo%3D&st=2024-11-23T10%3A08%3A51Z&se=2024-11-23T12%3A13%3A51Z&sp=r
Upload Date:
2024-05-31T00:00:00.0000000
Transcript:
Language: EN.
Segment:0 .
Hello, with us today, I'm going to demonstrate to you a very important test for knee, which is called Lelli's test. It is also called as lever test. It is an extremely important test in order to find out if the ACL is ruptured or not. There are many occasions where a patient comes to you acutely in the clinic, and it's very difficult to perform a Lachman test because knee is acutely painful.
Now this test can be easily performed even in acute setting, and this can be performed even if the patient has injured his knee a few hours ago. So there are two important reasons I would recommend this. First is because you can do this test acutely. Secondly, it gives a very important information about functionality of the ACL. There are many occasions where ACL is partially ruptured.
And whether the ACL is functionally competent or not, you can do either a pivot shift test, which is a very difficult test unless and until the patient is anesthetized or you have got a good experience in performing that test, or you can do the Lelli's test. If the Lelli's test is negative, that means even in a partial tear ACL is functional and the patient can be treated non operatively. So in order to do a Lelli's test, you need to be patient supine on the table.
So today I'm going to examine this patient's left knee. MRI has suggested that there is a partial injury to his ACL, and I want to check whether this ACL is functionally competent or not. So in order to do this test, the first thing I'm going to do is I'm going to place my left fist under the patient's calf. So just like this. And then with the other hand, with my right hand, I'm just going to apply a moderate force.
So just a simple force or I can use just a single finger. And if you see, when I press my finger, if you focus on the patient's heel, the heel is coming off the examination couch. So I'll just show you again, but only if you can focus on the heel. I'm pressing it on the top and you can see the ACL is intact and it is pushing the heel off the table. So I'll show you again here.
So if the ACL was completely torn or functionally incompetent when I press this heel will remain on the examination bed. And that will be a positive test, suggestive of a complete tear or a functionally incompetent ACL. So in the previous patient you saw that Lelli test was negative. When I was putting my hand under the calf and was using a moderate force under, the foot was coming off the examination couch.
And now I have another gentleman who unfortunately injured his knee a year ago. And if we examine the knee on this occasion, it's the same thing. If I put the hand under the calf and I just use a moderate force, I'm doing it. You can see the foot on this occasion is not coming off the couch. So if the foot is not coming off the couch, then this signifies a significant either a complete tear or a dysfunctional ACL.
So I just repeat again, if I do this, I'm using a good amount of force and the feet is not coming off. This is a classically positive Lelli's test. This was a demonstration on how to do a Lelli's test. This test is extremely underutilized and a lot of surgeons, they don't know about this test and they are not aware about it. I use this test routinely in my practice. And I find it very, very useful.
So I hope you like this video. Please give us a thumbs up. Do subscribe and do share our channel. Thank you.
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