Which step is part of anterior tibia HVLA?

• A. Flex the knee to 90 degrees, anchor the foot, apply posterior pressure to the tibia, then perform a thrust posteriorly along the femur
• B. Extend the knee fully and apply an anterior thrust
• C. Place the patient prone and apply lateral traction to the tibia
• D. Circle the knee while applying rotational forces to the tibia

Answer: (A)

An anterior tibia HVLA aims to produce a quick, high-velocity anterior glide of the tibia within the knee joint. To set up this movement, the knee is flexed to about 90 degrees so the tibia can move forward relative to the femur, and the foot is anchored to fix the distal segment. Applying a posterior pressure to the tibia helps preload and align the joint so the thrust can work effectively. The rapid thrust is then directed along the axis of the femur, driving the tibia anteriorly and restoring proper motion. This combination—90-degree knee, stabilized distal segment, posterior preload, and a brief, high-velocity thrust along the femur—characterizes the anterior tibia HVLA.