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.

21 OF THE MOST USEFUL ORTHOPAEDIC TESTS IN CLINICAL PRACTICE

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

• Slocum Test (Anterolateral Rotatory Instability)
• Giving Way Test of Jakob (Anterolateral Rotatory Instability)
• Lemaire Jolt Test (Anteromedial Rotatory instability)
• Reverse Pivot-Shift Test (Posterolateral Rotatory Instability)
• Dial Test (Posterolateral Rotatory Instability)
• Frog Leg Test (Posterolateral Rotatory Instability)

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.