Losee R E
Clin Orthop Relat Res. 1983 Jan-Feb(172):45-51.
The pivot shift is a symptom and sign of anterior cruciate ligament (ACL) and lateral and posterolateral capsular deficiency of the knee. Either a subluxation or reduction, or both in rapid succession, plus a simultaneous impingement of the lateral compartment of the knee causes a pivot shift. The knee must twist to sublux the lateral tibial plateau anteriorly and the lateral femoral condyle posteriorly, to cause a misfit of the joint; the knee must be partially flexed to sublux symptomatically; the lateral compartment of the misfitted joint must be compressed simultaneously during a twist into or out of subluxation to cause impingement. When the knee is subluxed while compressing the lateral compartment and then flexed to more than 40 degrees, an intact iliotibial tract will cause reduction. However, an insufficient iliotibial tract will permit continued subluxation through further flexion.
轴移试验是前交叉韧带（ACL）以及膝关节外侧和后外侧关节囊缺损的一种症状和体征。膝关节的半脱位或复位，或两者快速连续发生，再加上膝关节外侧间室的同时撞击，会导致轴移试验阳性。膝关节必须扭转以使外侧胫骨平台向前半脱位，外侧股骨髁向后半脱位，从而导致关节不匹配；膝关节必须部分屈曲才能出现有症状的半脱位；在扭转进入或离开半脱位状态时，必须同时压缩不匹配关节的外侧间室以引起撞击。当在压缩外侧间室的同时膝关节半脱位，然后屈曲超过40度时，完整的髂胫束会导致复位。然而，髂胫束不足会导致通过进一步屈曲持续半脱位。
