Grading the pivot shift. Objective tests with implications for treatment

J Bone Joint Surg Br. 1987 Mar;69(2):294-9. doi: 10.1302/0301-620X.69B2.3818763.


A logical, objective and reproducible grading system for the pivot shift test is proposed. The rationale is based on performing the examination in varying positions of rotation of the tibia, allowing the type and degree of the different laxities to be defined and quantified. The system has been assessed against a new "unblocked" test for anterior subluxation and against radiographic measurements, operative findings and results. This grading system can be valuable in pre-operative assessment and planning and its use in postoperative evaluation would enable results from different centres and different procedures to be compared more accurately.

MeSH terms

  • Humans
  • Joint Dislocations / classification
  • Joint Dislocations / diagnosis*
  • Joint Dislocations / physiopathology
  • Joint Instability / classification
  • Joint Instability / diagnosis
  • Joint Instability / physiopathology
  • Knee Injuries / classification
  • Knee Injuries / diagnosis*
  • Knee Injuries / physiopathology
  • Knee Joint / diagnostic imaging
  • Knee Joint / physiopathology
  • Methods
  • Movement
  • Radiography