ACL Rehabilitation in Tambaram
ACL Rehabilitation
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Pivot Shift Test:
Definition/Description:
The pivot shift is a dynamic but passive test of knee stability, carried out by the examiner without any activity of the patient. It shows a dysregulation between rolling and gliding in the kneejoint. The patient lies in supine. The movement is a combination of axial load and valgus force, applied by the examiner, during a knee flexion from an extended position. When the test is positive, it indicates an injury of the anterior cruciate ligament.
Purpose
The purpose of this test is to detect anterolateral rotary instability of the knee. The structures that could be compromised if this test is positive are the ACL, LCL, posterolateral capsule, arcuate complex and ITB.
Technique
The patient lies supine with legs relaxed. The examiner grasps the heel of the involved leg with examiners opposite hand placed laterally on the proximal tibia just distal to the knee.
The examiner then applies a valgus stress and an axial load while internally rotating the tibia as the knee is moved into flexion from a fully extended position.
Positive Test:
A positive test is indicated by subluxation of the tibia while the femur rotates externally followed by a reduction of the tibia at 30-40 degrees of flexion.