Isolated partial rupture of the anterior cruciate ligament Long-term follow-up of 56 cases

Abstract

The majority of previous studies on partial ruptures of the anterior cruciate ligament (ACL) include a relatively large proportion of knees with associated intra-articular injury or collateral ligament tear that contributes to an increase in the symptoms of instability and further deterioration of knee function. In the present study only patients with isolated, partial ruptures of the ACL were evaluated. Fifty-six patients with one injured knee were examined after a median of 5.3 (range 2.0-12.7) years using the IKDC evaluation form, Lysholm knee function score and Tegner activity score. Of the 56 knees, 6 underwent autologous reconstruction due to early progression to complete rupture. Of 34 knees evaluated for laxity, 25 had a negative Lachman test and 7 a positive (+) Lachman. In 2 knees a Lachman ++ result and a positive pivot shift were found. With instrumented laxity testing 24 knees had 2 mm or less difference in laxity compared with the contralateral uninjured knee. The largest side-to-side difference in knee laxity was 4.5 mm. Lysholm score was median 86 (range 52-100) points, and 62% had good or excellent knee function. A significant decline in activity was seen. Only 10 patients (30%) resumed their preinjury activities. We find that the majority of patients with an isolated, partial rupture of the ACL have an acceptable knee function and a stable knee after a median 5 years follow-up. There is, however, a marked reduction in activity.

Anterior cruciate ligament assessment using arthrometry and stress imaging

“…Some literature suggests that the majority of partial tears have laxity increases of <3 mm and are undetectable with laximetry [78,[88][89][90][91][92]. However, one group using the GNRB arthrometer found 80 % sensitivity and 87 % specificity with their protocol [50].…”

Pediatric ACL injuries: evaluation and management

“…Partial ACL injuries occur on a spectrum making study of the natural history of these injuries impossible. The literature has wide ranging results of knee outcomes scores and progression to complete rupture [22][23][24][25]. While the pivot shift may be provide information as to whether a partial ACL injury should be reconstructed, the diagnosis of a partial ACL tear cannot be made based on physical examination alone.…”

Wear Patterns in Knee Articular Surfaces in Varus Deformity

“…This meant that completely normal ligaments (typically in knees with minimal deformity) and attenuated ligaments were both pooled in the "intact" group. In theory, it would have been possible to use a 3-level classification system in which thinned or attenuated ligaments formed a separate group, as proposed by previous authors for acute ACL injuries in adults [26][27][28] and children [29]. However, studies by Waldstein et al [30] and Johnson et al [31] have shown that MR imaging may be necessary to adequately and reliably characterize the integrity of the ACL.…”