Full recovery of near complete tear of anterior cruciate ligament without surgery

Background: Partial anterior cruciate ligament (ACL) tears are observed in 10% to 27% of isolated ACL tears. There is currently no consensus on diagnosis and treatment protocols, and the outcomes of nonoperative treatment remain undefined. Purpose: To assess the incidence and risk factors for the progression of partial ACL tears to complete ruptures after nonoperative treatment in active patients younger than 30 years. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 41 patients, all younger than 30 years and active in sports, were diagnosed with a partial ACL tear, with no associated meniscal or chondral lesions on magnetic resonance imaging (MRI). All were assigned to a nonoperative treatment program. The Lachman test, ≤4-mm side-to-side difference in laxity by Rolimeter, and MRI were utilized for the diagnosis. Tegner and International Knee Documentation Committee (IKDC) scores were assessed before and after the first lesion, and the Anterior Cruciate Ligament Return to Sport After Injury (ACL-RSI) score was assessed at last follow-up. Postinjury Tegner and IKDC scores were assessed before the second injury for patients progressing to a complete ACL tear and at last follow-up for patients without progression. Results: At a mean of 43 months (range, 24-96 months), the partial ACL injury progressed to a complete ACL tear in 16 (39%) patients. In the remaining 25 patients without progression, the mean Tegner and IKDC scores were 7.0 and 96.0 before the injury and 5.9 and 85.7, respectively, at last follow-up. The mean ACL-RSI score was 69.3. The Tegner and IKDC scores were significantly lower at final follow-up ( P = .0002 and P < .0001, respectively). Only 18 (44%) patients returned to their preinjury level of sports activities. A significantly increased risk of progression to a complete ACL tear was seen in patients ≤20 years (odds ratio, 5.19; P = .037) or patients practicing pivoting contact sports (odds ratio, 6.29; P = .026). Meniscal lesions were found in 50% of patients with a partial tear that progressed to a complete ACL tear. Conclusion: A partial ACL injury progressed to a complete ACL tear in 39% of young active patients treated conservatively, with half of the complete tears presenting with a concomitant meniscal lesion at the time of reconstruction. Age ≤20 years and participation in pivoting contact sports were identified as significant risk factors for progression to a complete tear.

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Partial and complete tear of the anterior cruciate ligament: Direct and indirect MR signs

Acta Radiologica ◽

10.1258/rsmacta.43.5.511 ◽

2002 ◽

Vol 43 (5) ◽

pp. 511-516 ◽

Cited By ~ 8

Author(s):

W.-T. Chen ◽

T. T.-F. Shih ◽

H.-Y. Tu ◽

R.-C. Chen ◽

W.-Y. Shau

Keyword(s):

Anterior Cruciate Ligament ◽

Pulse Sequence ◽

Cruciate Ligament ◽

Lateral Meniscus ◽

Lateral Compartment ◽

Posterior Horn ◽

Acl Tear ◽

Complete Tear ◽

Bone Contusion ◽

Anterior Cruciate

Purpose: To analyze MR direct and indirect signs for knees with anterior cruciate ligament (ACL) partial or complete tear. Material and Methods: According to documented MR direct and indirect signs for ACL tear, we retrospectively reviewed the incidence of those signs in 15 partial ACL tear and 17 complete ACL tear patients. The findings were also compared with duration of injury (less or more than 6 weeks, as acute or chronic stages). Results: A residual straight and tight ACL fiber in at least one pulse sequence was more frequently detected in partial ACL tears. The empty notch sign, a wavy contour of ACL, bone contusion at lateral compartment and lateral meniscus posterior horn tear were significantly more frequently seen in complete tear cases. The posterior cruciate ligament angle in chronic complete ACL tear cases (109°±20°) had a tendency to be less than in chronic partial ACL tear cases (119±18°). Conclusion: The empty notch sign, a wavy ACL, bone contusion, and posterior horn of lateral meniscus tears are suggestive of a complete ACL tear. A residual straight and tight ACL fiber seen in at least one image section is a helpful sign to diagnosis of partial ACL tear. In the acute ACL injury stage, a focal increase of the ACL signal intensity is more suggestive of a partial ACL tear.

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Complete tear of the lateral meniscus posterior root is associated with meniscal extrusion in anterior cruciate ligament deficient knees

Journal of Orthopaedic Research® ◽

10.1002/jor.23861 ◽

2018 ◽

Vol 36 (7) ◽

pp. 1894-1900 ◽

Cited By ~ 6

Author(s):

Yusuke Kamatsuki ◽

Takayuki Furumatsu ◽

Masataka Fujii ◽

Yuya Kodama ◽

Shinichi Miyazawa ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Cruciate Ligament ◽

Lateral Meniscus ◽

Posterior Root ◽

Meniscal Extrusion ◽

Complete Tear ◽

Anterior Cruciate ◽

Anterior Cruciate Ligament Deficient

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Anterior cruciate ligament reconstruction and rehabilitation: predictors of functional outcome

Joints ◽

10.11138/jts/2015.3.4.179 ◽

2015 ◽

Vol 03 (04) ◽

pp. 179-185 ◽

Cited By ~ 13

Author(s):

Francesco Della Villa ◽

Margherita Ricci ◽

Francesco Perdisa ◽

Giuseppe Filardo ◽

Jacopo Gamberini ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Recovery Of Function ◽

Cruciate Ligament ◽

Young Patients ◽

Activity Level ◽

Full Recovery ◽

Surgical Reconstruction ◽

Isokinetic Test ◽

Anterior Cruciate

Surgical reconstruction of an injured anterior cruciate ligament (ACL) leads to full recovery of function and sports activity in a high percentage of cases. The aim of the present study was to analyze variables related to the patient, the surgical technique and the post-surgical rehabilitation methods, seeking to identify predictors of outcome and recovery time after ACL reconstruction.One hundred and four patients (81 M, 23 F) undergoing a step-based rehabilitation protocol after ACL reconstruction were evaluated. 43.2% of them had an isolated ACL lesion, whereas 56.8% had one or more concurrent injuries. Data relating to personal characteristics, surgery and post-operative management were collected and analyzed for correlation. Clinical outcome was evaluated with IKDC subjective score and the Tegner score, and the time to reach full recovery was noted as well.Young patients with a higher pre-injury Tegner activity level or who practice sport at professional level, no concurrent capsular lesions and no postoperative knee bracing had better clinical results and took shorter time to recover. Also, a higher percentage of on-thefield rehabilitation sessions, and absence of significant muscle strength deficits at the first knee isokinetic test emerged as rehabilitation-related factors leading to a better post-surgical outcome.Personal, surgical and rehabilitation factors should be considered in order to optimize patient management and maximize the expected results. Further studies are needed to find the strongest factors in different patients. Level of evidence: Level IV, retrospective study.

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