ACL Evaluation:Positive Lachman's Test & Positive Reverse Pivot Shift Test

In this video I do an evaluation of a young man who has a torn ACL with some poster-lateral instability. I demonstrate and explain the Lachman's test, Brush test, the Reverse Pivot Shift test and explain the mechanism of injury along with the common findings in a patient with an ACL tear
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#ReversePivotShift#ACLtear#Lachman'sTest

[@jacobbonville2897]

Hi Paul,
I am just commenting to say that I am in my 1st year of my Masters of Athletic Training now and have watched this video multiple times to help understand the knee special tests. Kind of fun watching positive special tests on my own knee, but it's even more fun thinking about what a good job you did in my rehabilitation. I hope you are doing well.
Thanks again!

[@BBwisco]

Never heard of reverse pivot shift or brush test. Good stuff.

[@arunagreen8119]

Hope is good after his surgery now! Im 53 and had the surgery. I feel for the youngsters with this injury and wish them all the best as its so tough!

[@OrthoEvalPal]

Yes he did. Thanks for taking the time to comment Aruna!

[@usmanarif2086]

great video ..keep up the good work

[@indiandoctor3864]

Paul you are amazing 👌

[@cristinabaca2058]

Great vid. Just wish it had included bilateral comparison. Good visual for students learning special tests to see a positive vs negative

[@OrthoEvalPal]

Here you go Christina...ua-cam.com/video/P3iNyTBJUPQ/v-deo.html

[@TherapeuticTactics]

I appreciate the content

[@OrthoEvalPal]

Thanks Ron! More to come.

[@amirdawood91]

useful thank you so much

[@24peppermintpatty]

As a student do you have a mnemonic or specific order in which you test?

[@jordanchang9348]

Very Nice Video!

[@OrthoEvalPal]

Thanks Jordan!

[@jayyrelaxation6555]

Thanks Paul. Great video.. Just want to ask if can MRI findings be mismatching with the clinical presentation of the patient sometimes?

[@OrthoEvalPal]

Yes Honshi, it can. Not as much anymore, but I have seen it. Mri quality is much better these days.

[@user-vh9uq4uu5v]

Hi Paul, If the patient experienced a sprain/tear to the ACL. Would the knee have the tendency to give way going up or down stairs?

[@megswearingen2494]

A long time ago I had a mishap at work and I tripped over a pallet backwards and I heard a loud pop in my left knee. I suspect I may have torn my acl but I’m not sure if I did or not. I can’t have it properly looked at my insurance won’t cover it. I’m scared there’s something really wrong with it. What should I do?

[@user-rh6fb7qe2v]

Is reverse pivot shift test for ACL or PCL . Plz answer me 😞😞

[@thecommercekaksha3131]

I am 20 year old around 4 month back my scooter slips toward right leg and my right knee got injured after that there was little swellling around and pain is occassionally and difficulty in walking and doing other activities I consulted to the doctor he done a x ray and said that the cartilage are being pressed and suggest to lose weight , not to bend it full , claim stairs I follow the same I lack to loseweight .Now the pain is occassionally when I stand and walk little more and not able to walk speedy , I m able to walk slowly and tired after little walk or stand

[@aditiyadav274]

Great video i also wanna do it now😂

[@lauriL90]

im 30 and somehow got acl avulsion fracture that is more common for kids. Lachman seems positive but other tests negative. Now i dont really know if fracture is partial or full. Right now plan is to wait 3 months and see if it improves or starts to effect my everyday life.

[@OrthoEvalPal]

Definitely up to the orthopedic doctor.

[@indiandoctor3864]

Will these test be positive in partial acl tear?

[@OrthoEvalPal]

Partial tears are tough. The endpoint that you feel when doing a Lachman's test can be a bit soft or mushy with partial tears. A partial tear will still cause an effusion which will cause a flexed knee gait and quadriceps suppression. Good question!

[@rushabhoza2276]

Isn’t reverse pivot shift test for PCL ?

[@stevenson9605]

I was thinking the same thing

[@daisystrait]

Ive already had 2 surgeries😭 I DONT WANNA GET ANOTHER ONE WAAAAA

[@zohrehfarjami3815]

👍🏻🙏

[@SV-uy4uy]

Why do you seldomly do the anterior drawer test?

[@OrthoEvalPal]

Good question Sam. I find that the patient doesn't relax very well and they can hold the tibia from migrating forward with that test by contracting their hamstrings.

[@SV-uy4uy]

@@OrthoEvalPal Thanks! Do you like the reverse pivot shift more than the regular pivot shift? Reasoning?