A no-touch test for the anterior cruciate ligament.

strate loss of integrity of the anterior cruciate ligament. These include the anterior drawer test, the Lachman test, the jerk test and the pivot shift test. Their usefulness in the acute case is often limited because of pain and swelling. The test which we describe is painless, noninvasive and accurate. Pathomechanics. The concept of the pivot shift, although attributed to Losee and first published by Galway, Beaupr#{233}and MacIntosh ( 1972), was discussed by Palmer in 1938. He wrote of”the lateral femoral condyle, rolling over the posterior margin of the lateral meniscus with loss of the anterior crucial band, making a circular motion around the medial”. These concepts form the basis of our test which might also be called an active Lachman. In our test, when the knee is between 30#{176} and 40 of flexion, the lateral tibial plateau is in a reduced position; with active extension, the quadriceps and iliotibial band pull the tibia into a subluxated position.