Knee Assessment

Cross Over Test | Anterolateral Rotatory Instability

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Cross Over Test | Anterolateral Rotatory Instability

James Arnold (1979) noted that eliciting a pivot shift or jerk test in athletic patients with muscular guarding was sometimes difficult and therefore he proposed the crossover test. However, no diagnostic accuracy studies have included the crossover test so no statistical values are available and the clinical value remains questionable.

To conduct the test, the patient is in standing position and crosses the unaffected leg over the affected leg keeping the foot of the affected leg flat on the floor.

Gently step on the affected foot to fixate it and ask the patient to rotate their torso as far as possible with the quadriceps contracted.

This position should reproduce a lateral pivot shift and symptoms of “the knee wanting to go out” in case of anterolateral rotatory instability.

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Other common tests to assess for rotatory instability of the knee are:

 

References

Arnold, J. A., Coker, T. P., Heaton, L. M., Park, J. P., & Harris, W. D. (1979). Natural history of anterior cruciate tears. The American journal of sports medicine, 7(6), 305-313.

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