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Related Experiment Video

Updated: Dec 23, 2025

Computerized Dynamic Posturography for Postural Control Assessment in Patients with Intermittent Claudication
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Objectifying the Pivot Shift Test.

Alexandra Horvath1, Sean J Meredith2, Kyohei Nishida3

  • 1Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Sports Medicine and Arthroscopy Review
|April 30, 2020
PubMed
Summary
This summary is machine-generated.

The pivot shift test assesses knee instability after anterior cruciate ligament (ACL) injury. Noninvasive tools offer objective measurement, and considering other knee structures can improve outcomes.

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Area of Science:

  • Orthopedics
  • Sports Medicine
  • Biomechanics

Background:

  • The pivot shift test is crucial for evaluating rotatory instability in anterior cruciate ligament (ACL)-deficient knees.
  • A lack of consensus exists regarding a standardized pivot shift maneuver among clinicians.
  • Anatomic structures beyond the ACL significantly influence rotatory knee stability.

Purpose of the Study:

  • To review the pivot shift maneuver and its clinical applications.
  • To discuss objective measurement tools for quantifying rotatory knee instability.
  • To highlight the importance of considering factors beyond the ACL in surgical outcomes.

Main Methods:

  • Review of existing literature on the pivot shift test and measurement devices.
  • Description of traditional invasive and modern noninvasive measurement systems (electromagnetic, inertial sensors, imaging analysis).
  • Discussion of anatomical contributions to rotatory knee stability.

Main Results:

  • Noninvasive measurement systems (electromagnetic, inertial sensors, tablet-based imaging) provide validated, objective, and quantitative assessment of rotatory knee instability.
  • Factors such as tibial slope, anterolateral structures (e.g., iliotibial band), and menisci play a role in rotatory stability.
  • Addressing these structures during ACL surgery may reduce residual pivot shift.

Conclusions:

  • Objective measurement tools are valuable for assessing rotatory knee instability.
  • A comprehensive surgical approach addressing multiple knee structures can potentially improve outcomes after ACL reconstruction.
  • Standardization of the pivot shift test and its objective measurement remains an area for development.