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The pivot-shift test [1] is one of the three major tests for assessing anterior cruciate injury or laxity, the other two being the anterior drawer and Lachman test. However, unlike the other two, it tests for instability, an important determinant as to how the knee will function. [ 1 ]
The pivot-shift test involves flexing the knee while holding onto the ankle and slightly rotating the tibia inwards. [28] In the anterior drawer test, the examiner flexes the knees to 90 degrees, sits on the person's feet, and gently pulls the tibia towards themself. [29] The Lachman test is performed by placing one hand on the person's thigh ...
Reverse Pivot Shift Test - The reverse pivot shift test is almost exactly as its name implies, a reverse of the pivot shift test. The patient lies on their back with their knee flexed to between 45° and 60° and their foot externally rotated. The practitioner applies a valgus force while slowly extending the knee.
If the anterior movement of the affected knee is greater than the unaffected knee, then the anterior drawer test is positive. The Lachman test is more sensitive than the anterior drawer test. For the Lachman test, the person lies down in supine position with the knee flexed at 20 degrees and the heel touching the bed. The tibia is then pulled ...
In order to perform the test, the patient lies prone (face-down) on an examination table and flexes their knee to a ninety degree angle. The examiner then places his or her own knee across the posterior aspect of the patient's thigh. The tibia is then compressed onto the knee joint while being externally rotated. If this maneuver produces pain ...
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Distraction tests: positive tests are rechecked when the patient's attention is distracted, such as a straight leg raise test; Regional disturbances: regional weakness or sensory changes which deviate from accepted neuroanatomy; Overreaction: subjective signs regarding the patient's demeanor and reaction to testing
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