Quantifying the Forces During the Pivot Shift Test
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The forces needed to elicit the pivot shift remain largely unknown, especially from a quantitative perspective. Previous research has demonstrated that there are three general components of external forces necessary to elicit the pivot shift test: (1) valgus stress, (2) axial compressive stress, and (3) internal rotational stress during the pivot shift test. At first, valgus stress is a requisite for the pivot shift test. Axial rotational stress should not be consistent in order to maximize the pivot shift movement. The dislocation of the lateral compartment is intensified by applying internal rotational stress, whereas the reduction movement is enhanced by applying external rotational stress. Changing the rotational force from internal to external depending on the phase of the pivot shift is preferable to highlight the pivot shift phenomenon. Also, another key force necessary to elicit a pivot shift is an axial compressive force. The examiner must carefully increase axial compression until the knee nears 30° of flexion, which is where the sudden reduction begins to happen. However, the exact amount of the force during the pivot shift test remains unknown. Investigation of the applied force to the knee during the pivot shift test is warranted to improve clinical usability of the pivot shift test and to contribute to the future development of an automated pivot shift test.
KeywordsPivot Shift Pivot Shift Test Anterior Tibial Translation Iliotibial Band Valgus Stress
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