A positive Pivot Shift test indicates ACL pathology?

A positive Pivot Shift test indicates ACL pathology?

• A. Rule In
• B. Rule Out
• C. Both
• D. Neither

Answer: (A)

Pivot shift tests evaluate rotational stability of the knee by challenging the ACL’s restraint to anterior translation combined with internal rotation. A positive result—usually a palpable clunk or subluxation that reduces as the knee is flexed—signals that the ACL is insufficient and rotationally unstable. This finding increases the likelihood of ACL pathology, so the test is used to rule in ACL injury rather than rule out. It’s worth noting that while a positive pivot shift strongly supports ACL damage, a negative result doesn’t completely exclude it, because no single test is perfectly sensitive. The pivot shift also highlights anterolateral rotatory instability, which can be associated with combined injuries around the knee.

Pivot shift tests evaluate rotational stability of the knee by challenging the ACL’s restraint to anterior translation combined with internal rotation. A positive result—usually a palpable clunk or subluxation that reduces as the knee is flexed—signals that the ACL is insufficient and rotationally unstable. This finding increases the likelihood of ACL pathology, so the test is used to rule in ACL injury rather than rule out. It’s worth noting that while a positive pivot shift strongly supports ACL damage, a negative result doesn’t completely exclude it, because no single test is perfectly sensitive. The pivot shift also highlights anterolateral rotatory instability, which can be associated with combined injuries around the knee.