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Surgical management of partial tears of the anterior cruciate ligament

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Partial anterior cruciate ligament (ACL) tears involving the posterolateral (PL) bundle can lead to rotatory laxity of the knee, while tears involving the anteromedial (AM) bundle result in abnormal anteroposterior laxity of the knee. In this systematic review, we examine the best evidence on the management of partial tears of the ACL.

Methods

A comprehensive search of several databases was performed from the inception of the database to December 2011, using various combinations of keywords focusing on clinical outcomes of human patients who had partial tears of ACL and who had undergone ACL augmentation. We evaluated the methodological quality of each article using the Coleman Methodology Score.

Results

Ten articles published in peer-reviewed journals were identified (392 males and 242 females), with a mean modified Coleman methodology of 66.1 ± 10.2. Only two studies compared standard ACL reconstruction and augmentation techniques. No study has a sample large enough to allow establishing guidelines. Validated and standardized proprioception assessment methods should be used to report outcomes. Imaging outcomes should be compared to functional outcomes, and a control group consisting of traditional complete ACL reconstruction should be present.

Conclusion

There is a need to perform appropriately powered randomized controlled trials presenting clinical outcome with homogeneous score systems to allow accurate statistical analysis. ACL augmentation technique, preserving the intact AM or PL bundle of the ACL, is encouraging but currently available evidences are too weak to support his routine use in clinical practice.

Level of evidence

Systematic review, Level IV.

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Authors and Affiliations

  1. Department of Orthopaedic and Trauma Surgery, Campus Biomedico University of Rome, Via Alvaro del Portillo 200, Rome, Italy

    Rocco Papalia, Francesco Franceschi, Biagio Zampogna, Andrea Tecame & Vincenzo Denaro

  2. Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, 275 Bancroft Road, London, E1 4DG, UK

    Nicola Maffulli

Authors
  1. Rocco Papalia
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  2. Francesco Franceschi
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  3. Biagio Zampogna
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  4. Andrea Tecame
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  5. Nicola Maffulli
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  6. Vincenzo Denaro
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Corresponding author

Correspondence to Nicola Maffulli.

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Papalia, R., Franceschi, F., Zampogna, B. et al. Surgical management of partial tears of the anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc 22, 154–165 (2014). https://doi.org/10.1007/s00167-012-2339-1

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  • DOI: https://doi.org/10.1007/s00167-012-2339-1

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