Pivot Shift Test - Clinical Examination

Video Description

Read more about the Pivot Shift Test in the AMBOSS Library: https://go.amboss.com/Pivot

The Pivot Shift Test is a physical examination maneuver that assesses anterior cruciate ligament (ACL) integrity. The test is best conducted on a supine patient, with the knee completely extended and the hip at 20 degrees flexion. Remember the following sequence of actions to conduct the test properly :

1) Axial compression of the knee (applied from the heel end)
2) Internal rotation of the lower leg (applied from the heel end)
3) Valgus stress (applied at the knee joint)
4) Slow flexion of the knee and hip

If the ACL is torn, the tibial plateau jerks backward as the knee approaches 30° of flexion. At this point, the patient might also report a reproduction of the sensation of the "knee giving way", which he/she may have experienced while walking or descending a staircase.

Video Index:
0:06 - Principle of the test
0:58 - Performing the test
1:21 - Interpretation

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