Which test represents the reversed direction variant for ACL tear involving the posterior lateral capsule and IT band?

• A. Pivot Shift Test
• B. McMurray's Test
• C. Thessaly Test
• D. Reversed Pivot Shift Test

Answer: (D)

The key concept is identifying posterior lateral rotatory instability in an ACL-deficient knee by stressing the posterolateral corner structures, including the IT band. The reversed pivot shift test is a variant that uses the opposite direction of tibial movement and loading to provoke instability from those structures. When the knee is flexed and loaded with valgus force and lateral-rotational stress, then moved into extension, the posterolateral capsule and IT band restrain the tibia differently. In an ACL tear with PLC/IT band involvement, this reversed motion can produce a palpable clunk or sudden shift as the tibia relocates, highlighting the instability in the posterolateral corner. The other tests cited mainly assess meniscal pathology (McMurray’s, Thessaly) or the standard ACL-driven instability (pivot shift) and do not specifically target the posterolateral capsule/IT band interaction in the reversed direction.