The role of static and dynamic rotatory laxity testing in evaluating ACL injury

In this article, we discuss current topics for rotatory knee laxity. All tests for knee laxity have a value. Static knee laxity tests reveal information for each individual patient’s laxity status, especially compared to the contralateral side. Static knee laxity tests are simple to do, and some of them are instrumented, therefore quantifiable. Dynamic knee laxity tests are more complex. Dynamic stereo radiography (DSX) is considered the gold standard. Utilizing DSX, information can be gained on 3-D kinematics, functional joint space, and joint contact patterns. The disadvantage is that DSX is expensive and can only be performed in a laboratory environment. The pivot shift test is a unique test, because it is dynamic and easily performed in the office. However, it is subjective and only recently quantifiable. Future endeavors will attempt to improve the value of the pivot shift test by standardizing the test and improving measurement technologies, while keeping the pivot shift test simple and non-invasive.