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The Lever test can be used to examine for a torn ACL
May be helpful when examining larger patients
Place patient supine with both knees extended. Examiner places fist below the proximal third of patient’s calf.
With the other hand, the examiner presses down on the distal third of the patient’s quadriceps.
Positive test: A torn ACL disrupts the lever arm of the lower leg. The heel will not rise.
Negative test: An intact ACL allows the lever arm of the lower leg to lift the heel. The heel will rise.
More study is needed but reported sensitivities are similar to classic tests such as the anterior drawer or Lachman.