Clinical diagnosis of ACL tear was determined by positive findings on anterior drawer test, Lachmann's test, and
pivot shift test and of PCL tear by positive findings on posterior drawer test and posterior sag (Godfrey test).
Ligament laxity was assessed using Lachman's test, Anterior drawer's test and
Pivot shift test.
There was no anterior or posterior drawer, she was stable to varus and valgus stresses, and her
pivot shift test was negative.
Pivot shift test: The
pivot shift test is a dynamic test which also tests the integrity of the ACL.
The
pivot shift test has a favorable positive predictive value, and the Lachman test has a good negative predictive value.
The original
pivot shift test was demonstrated by Galway and Mc Intosh in 1972.
The posterolateral rotatory
pivot shift test is done with the forearm in pronation
Orthopaedic surgeons can clinically reproduce this symptom when performing the
pivot shift test, first described by Galway and colleagues in 1972, as reported here from a subsequent publication.
Clinically, the orthopedic literature abounds with several descriptions of physical examination procedures and diagnostic tests to specifically assess the integrity of the menisci, such as joint line tenderness (JLT), (24) Apley compression test, (23) Anderson medial-lateral grind test, (25) McMurray's test, (26) Bounce home maneuver (24) and newer tests such as the Axially loaded
pivot shift test, (10) KKU knee compression rotation test (27), Ege's test (22) and Thessaly test.
One of the most useful tests employed for chronic ACL insufficiency is the
pivot shift test, which assists in determining to what extent the ACL has been torn.
Reverse Lachman and reverse
pivot shift tests also demonstrated posterolateral laxity compared to the contralateral limb.
Clinical outcomes of both groups were compared using International Knee Documentation Committee (IKDC) and Lysholm scores, ROM, Lachman,
pivot shift tests, and patient satisfaction.
