Rotatory knee laxity tests and the pivot shift as tools for ACL treatment algorithm

Knee Surg Sports Traumatol Arthrosc. 2012 Apr;20(4):793-800. doi: 10.1007/s00167-011-1857-6. Epub 2011 Dec 30.


The goal of anterior cruciate ligament (ACL) reconstruction surgery is to eliminate the pivot shift phenomenon. Different injury mechanisms and injury patterns may lead to specific knee laxity patterns. Computer navigation is helpful for the surgeon during examination under anesthesia. Surgical treatment may have to be altered if high-grade laxity is detected preoperatively for example by utilizing a computer navigation that is a helpful adjunct for surgeons during examination under anesthesia. A typical case for revision ACL reconstruction is presented. This article describes several techniques of laxity assessments. Based on the type and degree of pathologic laxity, a treatment algorithm has been developed.

Level of evidence: V.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Algorithms*
  • Anterior Cruciate Ligament / surgery*
  • Anterior Cruciate Ligament Injuries
  • Anterior Cruciate Ligament Reconstruction / adverse effects*
  • Anterior Cruciate Ligament Reconstruction / methods
  • Arthrometry, Articular*
  • Biomechanical Phenomena
  • Follow-Up Studies
  • Football / injuries
  • Humans
  • Joint Instability / diagnosis
  • Joint Instability / surgery*
  • Knee Injuries / diagnosis
  • Knee Injuries / surgery
  • Male
  • Postoperative Complications / diagnosis
  • Postoperative Complications / surgery
  • Range of Motion, Articular / physiology
  • Reoperation / methods
  • Risk Assessment
  • Surgery, Computer-Assisted / methods*
  • Tenodesis / methods
  • Treatment Outcome