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The Apley grind test, also known as the Apley compression test or the Apley test, is a maneuver performed to evaluate meniscus injury. Clinicians usually perform it in conjunction with the Apley distraction test, which assesses for ligamentous injury. Meniscal injuries are very common and are associated with significant pain and morbidity. This activity describes the Apley grind test and its indications and contraindications and highlights the role of the interprofessional team in the management of patients with meniscus injuries. Objectives: Describe how the Apley grind test is performed. Review the implications of pain with compression during the Apley grind test. Summarize the contraindications to the Apley grind test. Explain strategies to optimize care coordination among interprofessional team members to improve outcomes for patients affected by meniscus injuries. Access free multiple choice questions on this topic.

The Apley grind or compression test is a physical examination maneuver first described by the British orthopedic surgeon Alan Graham Apley. It is commonly performed to evaluate potential meniscal injury of the knee, often in conjunction with the Apley distraction test. Meniscal injuries are prevalent and correlate with significant pain, morbidity, and missed time from school, sports, and work. Meniscal injuries are very uncommon in patients younger than ten years old. Males are afflicted more commonly than females, and the assumption is that this relates to males engaging in more activities involving rotational injuries, such as contact sports. Prompt diagnosis of these injuries with the proper physical examination, provocative tests such as the Apley grind test and Apley distraction test, and advanced imaging such as magnetic resonance imaging (MRI) are essential to provide appropriate treatment and a positive outcome for patients.[1]

There are no reported complications to the Apley compression test. While patients may experience localized knee pain, this is necessary to elicit, as that indicates a positive test. As stated in the contraindications section, this test should not be performed on a patient with gross deformity of the knee after major trauma. More serious complications can arise, such as worsening existing fractures or potentially converting a closed fracture to an open fracture.

Many interprofessional healthcare team members can perform the Apley compression test to assess for meniscal injury, including emergency and sports medicine providers, orthopedic nurses and surgeons, chiropractors, and physical therapists. However, it is crucial to understand that the test is not 100% sensitive, and an MRI should be utilized to confirm the diagnosis.[4] Patients with meniscal injuries should receive a referral to an orthopedic surgeon for definitive management.[1] Interprofessional activity coordination and open sharing of exam results and other case information will guide the management of knee injuries resulting in optimal outcomes.[Level 5]