The Lever Sign test is a manual test for anterior cruciate ligament laxity.
Page updated October 2023 by Dr Sheila Strover (Clinical Editor)
Initial reports of this test suggested it was very sensitive and specific for tears of the anterior cruciate ligament, but the early findings have not been that reproducible.
How is the lever sign test performed?
The patient lies on their back with the legs extended - with one hand over the quads and the other hand made into a fist under the calf, the examiner watches to see if the heel is levered up off the examination table. If the ligament is intact the heel should lift. If the ligament is torn, the heel should remain on the table.
Quick links
Peer-reviewed papers
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Quote:
"...the accuracy was similar in nonsurgical patients (awake in clinic, 76%) and in surgical patients (under anesthesia, 77%)."
Citation: Jarbo KA, Hartigan DE, Scott KL, Patel KA, Chhabra A. Accuracy of the Lever Sign Test in the Diagnosis of Anterior Cruciate Ligament Injuries. Orthop J Sports Med. 2017 Oct 11;5(10):2325967117729809. doi: 10.1177/2325967117729809. PMID: 29051898; PMCID: PMC5639970.