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hey everybody this is Paul from ortho develop palette today I want to talk about the reverse pivot shift test for ACL tears and as luck has it we have a young man here who has an ACL tear heamp;#39;s going to be having surgery soon and Iamp;#39;d like to do the reverse pivot shift after the Lockman test the Lockman is the least invasive most tolerated by patients but if theyamp;#39;re not having a lot of this comfort not a lot of swelling and they can relax pretty well then you might get a nice reverse pivot shift and the way you do that test is you flex the knee to about 90 degrees take your other hand put it on the tibia and I kind of keep this elbow next to the foot and I externally rotated tibia a little and as we put them into varus we extend him okay as we extend them youamp;#39;re going to feel this little knockin sensation or the tibia kind of instead of screwing home nicely as you extend it kind of comes like this and then suddenly falls into place okay so Iamp;#39;ll go