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Pivot shift test

The pivot shift test is a test to assess the integrity of both the anterior cruciate ligament and and also the other key structures that contribute to the knee's stability.

The patient lies on his/her back with the hip flexed to 30 degrees. The surgeon may bend the patient's knee to 20 degrees and tuck the foot under the surgeon's arm to hold it stable. One hand rests lightly on the outer aspect of the knee, and the other holds the lower leg and controls the process. The knee is slowly flexed and gently inwardly rotated.

If the test is positive, one sees or feels a sudden pivot of the tibia bone on the outer side due to structural instability.

This YouTube video gives an idea - watch the thumb of the surgeon's left hand -