Spontaneous healing of acute anterior cruciate ligament (ACL) injuries - conservative treatment using an extension block soft brace without anterior stabilization

Fujimoto, Eisaku; Sumen, Yoshio; Ochi, Mitsuo; Ikuta, Yoshikazu

doi:10.1007/s00402-001-0387-y

Cited by 81 publications

(59 citation statements)

References 16 publications

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“…However, several studies have reported a spontaneous healing of the ACL after acute rupture [4,6,8], and in most cases, the authors of these studies have indicated a nonoperative treatment with bracing and a specific rehabilitation program [4,6,8]. Thus, while most observers suggest a complete ACL rupture will not heal, there are apparently some situations in which it will heal.…”

Section: Introductionmentioning

confidence: 99%

Spontaneous Healing in Complete ACL Ruptures: A Clinical and MRI Study

Paz

Ayerza

Tanoira

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Most authors believe the ACL does not spontaneously heal after a complete rupture. Although several studies have reported spontaneous healing of torn ACLs, it is difficult to determine its healing potential and whether patients will be able to return to sports activities. Questions/purposes We therefore asked whether (1) a complete ACL rupture in patients can spontaneously heal without the use of a specific rehabilitation program or bracing and (2) patients are able to return to their athletic activity after spontaneous ACL healing. Patients and Methods We retrospectively reviewed 14 patients with acute ACL injury established by physical examination and MRI (proximal third in eight patients and the midligament in six). Average age at injury was 31 years (range, 23-41 years). All patients were athletically active before injury. Surgery was indicated in all patients but for various reasons postponed. We obtained International Knee Documentation Committee scores, Lysholm-Gillquist scores, and MRI. The minimum followup was 25 months (mean, 30 months; range, 25-36 months).

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Section: Introductionmentioning

confidence: 99%

Spontaneous Healing in Complete ACL Ruptures: A Clinical and MRI Study

Paz

Ayerza

Tanoira

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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“…Another possible explanation for the difference in PL bundle is that healing of a PL bundle with time may contribute to the more accurate rating of PL bundle integrity in the late MRI group. In fact, spontaneous healing of a torn ACL was demonstrated in several studies [2,8,11]. Nevertheless, further studies should be warranted to prove our speculation about the healing potential of the PL bundle.…”

Section: Discussionmentioning

confidence: 81%

How Useful Is MRI in Diagnosing Isolated Bundle ACL Injuries?

Chang

Choi

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Selective bundle anterior cruciate ligament (ACL) reconstruction and/or remnant ACL preservation may be reasonable options for some patients. However, the frequency of isolated anteromedial (AM) or posterolateral (PL) bundle injuries in patients undergoing ACL reconstruction is unknown, and the value of MRI for prediction of this injury pattern is likewise unknown. Questions/purposes We sought to determine (1) the proportion of knees with an intact AM or PL bundle in patients undergoing ACL reconstruction; (2) whether MRI predicted the bundle conditions seen at the time of surgery; and (3) whether the accuracy of the MRI prediction was affected by the timing of MRI after injury. Methods During primary ACL reconstructions of 156 knees, conditions of AM and PL bundles were separately examined and classified into three categories: (1) completely torn; (2) attenuated; and (3) intact. Then, the bundles were assessed by blinded observers on MRI and classified into the corresponding three categories for 77 patients who had an MRI at our institution using a standard protocol. Diagnostic accuracy of MRI was computed, and the early MRI group (B 6 weeks from injury to MRI acquisition) was compared with the late MRI group ([6 weeks). Results Only 11 (7%) of the 156 knees we treated had an intact AM (one knee) or PL bundle (10 knees). Another 55 knees (35%) had a structurally continuous but attenuated AM or PL bundle. The overall diagnostic accuracy of MRI was 83%; accuracy was better for the AM bundle than the PL bundle (91% versus 78%; p = 0.026). MR prediction was less accurate in the early MRI group, particularly for PL bundle injury.

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“…Any high signal intensity due to edema or bleeding from acute mechanical injury would be expected to decrease as the acute responses resolve. [21][22][23] The unaltered signal intensity also does not support the theory that acute ligament injury invisible on MR images in the acute phase can cause the development of high signal intensity seen only at a later stage of injury, eg, after a repair process or due to accelerated degeneration. 11 We cannot completely rule out that such high signal intensity may occur later than 12 months after injury.…”

Section: Discussionmentioning

confidence: 89%