Understanding the Pivot Shift Test Assessment
To dynamically assess for **anterolateral rotatory instability** of the knee, which is highly indicative of a **complete ACL tear**.
Watch How It's Done
How do I start?
Patient is supine. Knee is in full extension, and the hip is slightly flexed and abducted.
What happens?
The examiner applies an **axial compression** through the leg, a **valgus stress** to the knee, and **internal rotation** of the tibia. The knee is then slowly moved from extension into **flexion**.
In Plain English
What Does a Positive Result Mean?
A palpable **subluxation (clunk) of the tibia** occurs as the knee moves into flexion, followed by a sudden **reduction (shift)** as the ITB passes the axis of rotation.
Helpful Tip:
A positive test is very specific for ACL rupture. Grading is based on the magnitude of the shift (Glide, Jump, Gross).
Safety First
This guide is to help you understand what happens in a clinic. Do not try to diagnose yourself. If you have severe pain, swelling, or cannot put weight on your leg, please visit an urgent care center or your doctor immediately.
Other Knee Tests
Posterior Drawer Test of the Knee
To assess the integrity of the **Posterior Cruciate Ligament (PCL)**.
Posterior Sag Sign (Gravity Drawer Test)
To detect a rupture of the **Posterior Cruciate Ligament (PCL)** by observing the effect of gravity.
Slocum Test (Anterolateral Rotatory Instability)
To assess for **anterolateral rotatory instability** and the function of the **Anterolateral Ligament** (a dynamic variant of the Anterior Drawer).
Thessaly Test
To assess for **meniscal tears** by dynamically loading the meniscus in a weight-bearing, rotational manner.