The pivot shift is a test to detect anterolateral rotary instability. In my experience, I’m a bit concerned when I see a pivot shift grade 2 or above. If no self reported instability are reported, I would often be okay with laxity in anterior translation, but a positive pivot shift would make me concerned. Let me know what you think?
One study found that the pivot-shift test can revealed that in ACL injured knees, knees with lateral meniscus tear showed greater rotatory laxity compared with knees without meniscus tear.
In addition, lateral meniscus repair, and to
a lesser degree medial meniscus repair, reduced rotatory laxity during ACL reconstruction surgery. Therefore, the meniscus should be repaired as much as possible because of its role as a secondary stabilizer of rotatory laxity.
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