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Posterolateral Corner Injury
Posted: Nov 17 2011
C

Positive Reverse Pivot Shift

Plays: 308

Video Description

This physical examination test dynamically assesses for posterolateral knee rotation. A positive test is seen with injuries to the posterolateral corner (PLC).

With the knee flexed to 80°, a valgus and external rotational force is applied to the knee. The knee is then extended. If the tibia is posterolaterally subluxed, the iliotibial band will reduce it as it goes from a flexor to an extensor of the knee. Initiation of the reverse pivot shift test in a patient with a severe PLC injury (knee subluxed posterolaterally). As the knee is extended, the iliotibial band visibly reduces the posterolaterally subluxed tibia.

References:
LaPrade RF, Terry GC. Injuries to the posterolateral aspect of the knee. Association of anatomic injury patterns with clinical instability. Am J Sports Med. 1997 Jul Aug;25(4):433-8. Level of Evidence: 2.
PMID: 9240974 (Link to Abstract)
Bahk MS, Cosgarea AJ. Physical examination and imaging of the lateral collateral ligament and posterolateral corner of the knee. Sports Med Arthrosc. 2006 Mar;14(1):12-9. Review. Level of Evidence: 5 - Other.
PMID: 17135940 (Link to Abstract)
LaPrade RF, Wentorf F. Diagnosis and treatment of posterolateral knee injuries. Clin Orthop Relat Res. 2002 Sep;(402):110-21. Review. Level of Evidence: 5 - Other.
PMID: 12218476 (Link to Abstract)


This video was created by the Sports Medicine Institute at the Department of Orthopaedics at the University of Minnesota.

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