Pivot Shift: Difference between revisions
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== References<br> == | == References<br> == | ||
<references />Baxter R. Pocket guide to musculoskeletal assessment, second edition. Elsevier Science 2003. | <references /> | ||
1. <ref name="Baxter">Baxter R. Pocket guide to musculoskeletal assessment, second edition. Elsevier Science 2003.</ref> | |||
2. <ref>Lane CG, Warren R, Pearl AD. The pivot shift. J Am Acad Orthop Surg. 2008 Dec;16(12):679-88.</ref> | |||
3. | |||
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Purpose
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The purpose of this test is to detect anterolateral rotary instability of the knee. Structures compromised if this test is positive could be the ACL, LCL, posterolateral capsule, arcuate complex and ITB.
Technique
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The patient lies supine with legs relaxed. The examiner grasps the heel of the involved leg with examiners opposite hand placed laterally on the proximal tibia just distal to the knee. The examiner then applies a valgus stress while internally rotating the tibia as the knee is moved into flexion from a fully extended position1. A positive test is indicated by subluxation of the tibia while the femur externally rotations then reduction of the tibia at 30-40 degrees of flexion.
Evidence[edit | edit source]
The Pivot Shift test attempts to reproduce the rotary and transalatory instability in an ACL deficient knee2.
Traditionally, the Lachman was used more often to measure knee laxity due to its quantifiability, however recent advances in technology have allowed for more objective and measurable observations of the motions involved in the pivot shift and may lead to the ability to make the test quanitifiable for research2.
Resources[edit | edit source]
add any relevant resources here
References
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1. [1]
2. [2]
3.
