A 30-year-old footballer sustains a twisting injury to the knee. He felt a pop and his knee swelled immediately within 1 hour. On examination there is positive anterior drawer test and positive Lachman's test. The structure most likely injured is:

• A Posterior cruciate ligament
• B Anterior cruciate ligament ✓
• C Medial collateral ligament
• D Lateral meniscus

Explanation

Anterior cruciate ligament (ACL) rupture typically presents with immediate haemarthrosis (blood in joint within 1–2 hours of injury) and a pop sensation, followed by knee instability. The anterior drawer test and the more sensitive Lachman's test (performed with knee at 30° flexion) are both positive because of anterior tibial translation relative to the femur. PCL injury would give a positive posterior drawer test.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

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Written and medically reviewed by the StethoPrep medical team.