Reverse Pivot-Shift Test

Execution:

  1. Patient is in supine lying position with the hip and knee flexed to 90°
  2. The examiner brings the patient’s tibia into external rotation with his ipsilateral hand, while the contralateral hand applies a valgus force at the proximal lateral tibia. A compression force through the tibia is applied by the ipsilateral anterior superior iliac spine
  3. The examiner keeps the axial compression, valgus force and external rotation and extends the knee by shifting his body backwards

Positive Outcome: The tibia will subluxe posteriorly in the starting position and get reduced by the ITB at around 30° of flexion. The test is also positive in case of apprehension by the patient at around 30°.

 

Study Reliability Sn Sp LR+ LR-
Rubinstein et al. (1994) NA 26 95 50.11 0.11