Reverse Pivot Shift - Everything You Need To Know - Dr. Nabil Ebraheim HD

Dr. Ebraheim’s educational animated video describes the Reverse Pivot Shift test, when and how to perform it, its indications, and all you need to know about it. The reverse Pivot shift test helps to diagnose acute or chronic posterolateral instability of the knee. A significantly positive reverse Pivot shift test suggests that the PCL, the LCL, the arcuate complex and the popliteal fibular ligament are all torn. How do we perform the reverse Pivot shift test? The reverse Pivot shift test begins with patient supine with the knee in 90 degrees of flexion. Valgus stress is then applied to the knee with an external rotation force. Bring the knee from 90 degree of flexion to full extension. The tibia reduces from a posterior subluxed position at about 20 degrees of flexion. A shift and reduction of the lateral tibial plateau can be felt as it moves anteriorly from a posteriorly subluxed position. A clunk occurs as the knee is extended. This is called the reverse Pivot shift test because shift of the lateral tibial plateau occurs in the opposite direction of the true pivot shift (seen in ACL tears). If the tibia is posterolaterally subluxed, the iliotibial band will reduce the knee as the IT band transitions from a flexor to extensor of the knee. It is very important to compare this test to the contralateral knee. Pivot shift = ACL tear Reverse Pivot shift = posterolateral instability of the knee (injury to the posterolateral corner +/- PCL). Posterolateral corner injury includes the LCL, popliteal fibular ligament, arcuate complex and the lateral capsule. Become a friend on facebook: http://www.facebook.com/drebraheim Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC Donate to the University of Toledo Foundation Department of Orthopaedic Surgery Endowed Chair Fund: https://www.utfoundation.org/foundation/home/Give_Online.aspx?sig=29 Background music provided as a free download from YouTube Audio Library. Song Title: Every Step