Lateral pivot shift test. A, Position of patient for test on right knee. Weight of right lower extremity is borne on right heel. B, Same position viewed from above. Right thumb of examiner is placed behind fibular head, and index finger palpates anterior aspect of subluxated lateral tibial plateau. Left thumb is placed behind lateral femoral condyle (see text). C, With knee unsupported in valgus and tibia internally rotated on femur, knee is flexed by pushing anteriorly with both thumbs. Tibia is reduced from its anteriorly subluxated position by tension of iliotibial band as knee reaches 25 to 45 degrees of flexion. Reduction should be readily palpable.