Effect of Tourniquet Use on the Pivot Shift Test

Overview

This prospective study will evaluate whether tourniquet inflation affects the results of the pivot shift test in patients undergoing anterior cruciate ligament (ACL) reconstruction. The pivot shift test is commonly used to assess rotational instability of the knee in patients with ACL injury. In each participant, the pivot shift test will be performed under anesthesia before and after inflation of the thigh tourniquet, allowing the two conditions to be compared within the same patient. The study aims to determine whether tourniquet use changes the findings of the pivot shift examination. Understanding the possible influence of tourniquet inflation may help standardize intraoperative assessment of rotational knee instability and improve interpretation of the pivot shift test during ACL surgery.

Anterior cruciate ligament (ACL) deficiency may result in both anterior and rotational instability of the knee. The pivot shift test is commonly used to assess rotational instability and is frequently performed under anesthesia during ACL reconstruction. However, intraoperative factors may influence the findings of the examination. This prospective study is designed to investigate whether inflation of a thigh tourniquet affects the pivot shift test. Each participant will serve as their own control. After induction of anesthesia, the pivot shift test will be performed before tourniquet inflation and repeated after tourniquet inflation under the same operative conditions. The findings obtained under the two conditions will be compared to determine whether tourniquet inflation influences the assessment of rotational knee instability. The study may help clarify whether tourniquet status should be standardized when the pivot shift test is performed intraoperatively during ACL reconstruction.