Apley Compression Test • How to Test for Meniscal Damage

The Apley's grind test (Apley Compression test) is used to evaluate individuals for problems of the meniscus in the knee. This test is named after Alan Graham Appley (1914 - 1996), a British orthopedic surgeon, who discovered this assessment technique. The test is performed in conjunction with the Apley's distraction test.

Apley Compression Test

Indications for use

A clinician should suspect an injury to the meniscus when a patient presents with knee pain, particularly after a twisting type of injury when the foot is firmly planted on the ground. The injury may occur with or without an external force being applied to the knee. Usually, pain is located along the joint line of the knee. Common complaints are pain and mechanical complaints such as clicking, catching, locking, or inability to fully extend the knee. These injuries frequently occur in conjunction with ligamentous injuries. When an external force is applied to the lateral knee, it can result in the "unhappy triad." This group of injuries encompasses damage to the medial meniscus or lateral meniscus with concomitant injuries to the anterior cruciate ligament (ACL) and the medial collateral ligament (MCL). When performing a physical examination, joint line tenderness, joint effusion, and impaired range of motion are the most common findings.

Test Description

Appley's grinding test involves placing the patient in the prone position with the knee flexed to 90 degrees. The patient's thigh is then rooted to the examining table with the examiner's knee. The examiner laterally and medially rotates the tibia, combined first with distraction, while noting any excessive movement, restriction or discomfort. The process is then repeated using compression instead of distraction. If rotation plus distraction is more painful or shows increased rotation relative to the normal side, the lesion is most likely to be ligamentous. If the rotation plus compression is more painful or shows decreased rotation relative to the normal side, the lesion is most likely to be a meniscus injury.