How is the pivot shift test performed?
This test is performed with the patient lying in the supine position with the hip passively flexed to 30 degrees and it is important to abduct the hip to relax the iliotibial tract and allow the tibia to rotate. The examiner stands lateral to the patient on the side of the knee that is being examined.
What does it take to have a high grade pivot shift?
For the purposes of this review, primarily based on cadaveric studies, a high-grade pivot shift will be defined as an ACL-deficient knee with a pivot shift of grade 2 or 3 while a low-grade pivot represents an ACL-deficient knee with a pivot shift of grade 0 or 1.
What is pivot shift phenomenon?
The pivot shift has been described as a sudden rotation of the tibia relative to the femur for an ACL-injured knee under a valgus torque at low angles of knee flexion [43]. This rotation is a 3-dimensional motion which occurs about a series of axes.
What does a positive anterior drawer test indicate?
This test is done on your uninjured knee first to compare and check for differences. If the tibia, or shinbone, has more movement, or if the ligament is loose compared with the other knee, the anterior drawer test is considered to be positive.
What is Pivot injury?
General – Running/Pivoting/Jumping Sports Injuries A “noncontact” pivoting or cutting injury, whether a pop is felt or heard, is a common cause of ACL tears. This rotational injury of the knee can lead to instability and inhibit the ability to be active in sports (see ACL injuries).
What does Lachman’s test for?
The Lachman test is a specific clinical exam technique used to evaluate patients with a suspected anterior cruciate ligament (ACL) injury. The test relies on proper positioning and technique and is regarded as the most sensitive and specific test for diagnosing acute ACL injuries.
What is the best ACL test?
The Lachman test is the most accurate test for detecting an ACL tear. Magnetic resonance imaging is the primary study used to diagnose ACL injury in the United States. It can also identify concomitant meniscal injury, collateral ligament tear, and bone contusions.
What is valgus stress of the knee?
The valgus stress test, also known as the medial stress test, is used to assess the integrity of the medial collateral ligament (MCL) of the knee. MCL injuries are common in the athletic population and can occur as either isolated injuries, or combined with other structural injuries.
What is tibial shift?
The tibial lateral shift (figure 1), defined as the distance between the center of the intercondylar notch of the femur and midpoint of the tibial plateau, was measured using Image J software (US NIH, Bethesda, MD, http://rsbweb.nih.gov/ij/).
How accurate is the anterior drawer test?
Knee injuries are usually physically examined. These physical tests are often enough to find out if there’s an injury. Some studies show that the anterior drawer test is 94% accurate and is better at diagnosing a tear than imaging tests.
What does a negative anterior drawer test indicate?
A positive Lachman test or pivot test is strong evidence of an existing anterior cruciate ligament (ACL) tear, and a negative Lachman test is fairly good evidence against that injury. Although widely used, the anterior drawer is the least helpful maneuver for diagnosing an ACL tear.