What does the pivot shift test assess?

The pivot shift test is specifically designed to assess the integrity of the anterolateral structures of the knee, which includes the anterior cruciate ligament (ACL) and its associated mechanisms. When performing this test, the examiner applies a combination of valgus stress and internal rotation to the knee while flexing it. This maneuver aims to reproduce the subluxation and reduction of the knee joint that occurs in cases of anterolateral rotary instability, which often arises due to ACL injuries or damage to the associated soft tissue structures.

During the test, as the knee is flexed, a characteristic "pivot shift" sensation can be felt when the knee reduces into a stable position. This response is indicative of anterolateral rotary instability, helping clinicians determine if the ACL and supporting structures are intact or compromised.

The other options relate to different aspects of knee stability and injury. Medial collateral ligament instability is assessed through different tests focusing on varus stress. The integrity of the anterior cruciate ligament can be evaluated through other tests such as the Lachman test or the anterior drawer test. Meniscal tears are typically assessed using tests such as the McMurray test or the Thessaly test. Thus, the pivot shift test's specific focus on anterol