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Retrospective analysis and risk of progression of partial anterior cruciate ligament injuries in a young population

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Background

The anterior cruciate ligament (ACL) is a common knee ligament injury. Partial ACL tears are common, and at least 10–27% of isolated ACL tears are diagnosed as partial tears. Patients with partial tears have high risk of progression of tears to complete tears, which may require surgical reconstruction. The risk factors associated with the progression to a complete tear are poorly understood.

Methods

The present case–control study assessed the incidence and risk factors for the progression of conservatively treated partial ACL tears to complete tears in 351 patients younger than 45 years. The diagnosis of partial ACL tears was based on clinical evaluation, side-to-side difference on Rolimeter, and magnetic resonance imaging. These patients were managed conservatively and followed up for a mean of 17.5 months or until the progression of the tear into a complete tear, requiring surgery. The patients in whom the tear progressed to complete tear (group P) were compared with those in whom the tear remained stable for a minimum of 18-month follow-up period (group S).

Results

Of the 351 partial ACL tear patients, 166 (47.3%) patients progressed to a complete tear at a mean duration of 17.5 months, whereas the tear in 185 (52.7%) patients remained stable and did not progress to a complete tear. Group P had mean international knee documentation committee (IKDC) scores and Tegner scores of 95.7 ± 3.7 and 7.6 ± 1.6, respectively, before the injury, and scores decreased to 52.4 ± 4.1 and 5.7 ± 2.2, respectively, at the 24-month follow-up.

Conclusion

Partial ACL tear progressed to a complete tear in 47.3% of evaluated patients. The associated risk factors were age less than 35 years, rigorous physical activities, high ACL–Return to Sport after Injury score during early rehabilitation days, early return to activity, and pivoting contact sports.

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References

  1. Sanders TL, MaraditKremers H, Bryan AJ et al (2016) Incidence of anterior cruciate ligament tears and reconstruction: a 21-year population-based study. Am J Sports Med 44(6):1502–1507

    Article  PubMed  Google Scholar 

  2. Gianotti SM, Marshall SW, Hume PA, Bunt L (2009) Incidence of anterior cruciate ligament injury and other knee ligament injuries: a national population-based study. J Sci Med Sport 12(6):622–627

    Article  PubMed  Google Scholar 

  3. Colombet P, Dejour D, Panisset J-C, Siebold R (2010) Current concept of partial anterior cruciate ligament ruptures. Orthop Traumatol Surg Res 96(8):S109–S118

    Article  CAS  PubMed  Google Scholar 

  4. Bollen S (2000) Epidemiology of knee injuries: diagnosis and triage. Br J Sports Med 34(3):227–228

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Granan LP, Forssblad M, Lind M, Engebretsen L (2009) The Scandinavian ACL registries 2004–2007: baseline epidemiology. Acta Orthop 80(5):563–567

    Article  PubMed  PubMed Central  Google Scholar 

  6. Janssen KW, Orchard JW, Driscoll TR, van Mechelen W (2012) High incidence and costs for anterior cruciate ligament reconstructions performed in Australia from 2003–2004 to 2007–2008: time for an anterior cruciate ligament register by Scandinavian model? Scand J Med Sci Sports 22(4):495–501

    Article  CAS  PubMed  Google Scholar 

  7. Nordenvall R, Bahmanyar S, Adami J et al (2012) A population-based nationwide study of cruciate ligament injury in Sweden, 2001–2009: incidence, treatment, and sex differences. Am J Sports Med 40(8):1808–1813

    Article  PubMed  Google Scholar 

  8. Barrack RL, Buckley SL, Bruckner JD, Kneisl JS, Alexander AH (1990) Partial versus complete acute anterior cruciate ligament tears. The results of nonoperative treatment. J Bone Jt Surg Brit Vol 72(4):622–624

    Article  CAS  Google Scholar 

  9. Siebold R, Fu FH (2008) Assessment and augmentation of symptomatic anteromedial or posterolateral bundle tears of the anterior cruciate ligament. Arthroscopy 24(11):1289–1298

    Article  PubMed  Google Scholar 

  10. Duc SR, Zanetti M, Kramer J, Käch KP, Zollikofer CL, Wentz KU (2005) Magnetic resonance imaging of anterior cruciate ligament tears: evaluation of standard orthogonal and tailored paracoronal images. Acta Radiol 46(7):729–733

    Article  CAS  PubMed  Google Scholar 

  11. Temponi EF, de CarvalhoJúnior LH, Sonnery-Cottet B, Chambat P (2015) Partial tearing of the anterior cruciate ligament: diagnosis and treatment. Rev Bras Ortop 50(1):9–15

    Article  PubMed  PubMed Central  Google Scholar 

  12. Shino K, Inoue M, Horibe S, Nakamura H, Ono K (1987) Measurement of the anterior instability of the knee. J Bone Jt Surg (Br) 69(4):608–613

    Article  CAS  Google Scholar 

  13. Sonnery-Cottet B, Lavoie F, Ogassawara R, Scussiato RG, Kidder JF, Chambat P (2010) Selective anteromedial bundle reconstruction in partial ACL tears: a series of 36 patients with mean 24 months follow-up. Knee Surg Sports Traumatol Arthrosc 18(1):47–51

    Article  PubMed  Google Scholar 

  14. Dejour H, Bonnin M (1994) Tibial translation after anterior cruciate ligament rupture: two radiological tests compared. J Bone Jt Surg (Br) 76(5):745–749

    Article  CAS  Google Scholar 

  15. Garcés GL, Perdomo E, Guerra A, Cabrera-Bonilla R (1995) Stress radiography in the diagnosis of anterior cruciate ligament deficiency. Int Orthop 19(2):86–88

    Article  PubMed  Google Scholar 

  16. Lerat JL, Moyen B, Jenny JY, Perrier JP (1993) A comparison of pre-operative evaluation of anterior knee laxity by dynamic X-rays and by the arthrometer KT 1000. Knee Surg Sports Traumatol Arthrosc 1(1):54–59

    Article  CAS  PubMed  Google Scholar 

  17. Panisset JC, Ntagiopoulos PG, Saggin PR, Dejour D (2012) A comparison of Telos stress radiography versus rolimeter in the diagnosis of different patterns of anterior cruciate ligament tears. Orthop Traumatol Surg Res 98(7):751–758

    Article  PubMed  Google Scholar 

  18. Beldame J, Bertiaux S, Roussignol X et al (2011) Laxity measurements using stress radiography to assess anterior cruciate ligament tears. Orthop Traumatol Surg Res 97(1):34–43

    Article  CAS  PubMed  Google Scholar 

  19. Barrack RL, Buckley SL, Bruckner JD, Kneisl J, Alexander A (1990) Partial versus complete acute anterior cruciate ligament tears: the results of nonoperative treatment. J Bone Jt Surg Br 72(4):622–624

    Article  CAS  Google Scholar 

  20. Bak K, Scavenius M, Hansen S, Nørring K, Jensen K, Jørgensen U (1997) Isolated partial rupture of the anterior cruciate ligament long-term follow-up of 56 cases. Knee Surg Sports Traumatol Arthrosc 5(2):66–71

    Article  CAS  PubMed  Google Scholar 

  21. Frobell RB, Roos EM, Roos HP, Ranstam J, Lohmander LS (2010) A randomized trial of treatment for acute anterior cruciate ligament tears. N Engl J Med 363(4):331–342

    Article  CAS  PubMed  Google Scholar 

  22. Woo SL-Y, Vogrin TM, Abramowitch SD (2000) Healing and repair of ligament injuries in the knee. J Am Acad Orthop Surg 8(6):364–372

    Article  CAS  PubMed  Google Scholar 

  23. Irrgang JJ, Anderson AF, Boland AL et al (2001) Development and validation of the International Knee Documentation Committee subjective knee form. Am J Sports Med 29(5):600–613

    Article  CAS  PubMed  Google Scholar 

  24. Bohu Y, Klouche S, Lefevre N, Webster K, Herman S (2015) Translation, cross-cultural adaptation and validation of the French version of the Anterior Cruciate Ligament-Return to Sport after Injury (ACL-RSI) scale. Knee Surg Sports Traumatol Arthrosc 23(4):1192–1196

    Article  CAS  PubMed  Google Scholar 

  25. Evan IK, Evans IK M.D. Sports Medicine North Orthopedic Specialty Center One Orthopedics Drive Microsoft Word—acl recon 2.doc (www.sportsmednorth.com)

  26. Isberg J, Faxèn E, Brandsson S, Eriksson BI, Kärrholm J, Karlsson J (2006) KT-1000 records smaller side-to-side differences than radiostereometric analysis before and after an ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 14(6):529–535

    Article  PubMed  Google Scholar 

  27. Panisset J, Duraffour H, Vasconcelos W (2008) Clinical, radiological and arthroscopic analysis of the ACL tear: a prospective study of 418 cases. Rev Chir Orthop Reparatrice Appar Mot 94(8 suppl):362–368

    Article  PubMed  Google Scholar 

  28. Van Dyck P, De Smet E, Veryser J (2012) Partial tear of the anterior cruciate ligament of the knee: injury patterns on MR imaging. Knee Surg Sports Traumatol Arthrosc 20(2):256–261

    Article  PubMed  Google Scholar 

  29. Yao L, Gentili A, Petrus L, Lee JK (1995) Partial ACL rupture: an MR diagnosis? Skeletal Radiol 24(4):247–251

    Article  CAS  PubMed  Google Scholar 

  30. Van Dyck P, Vanhoenacker FM, Gielen JL et al (2011) Three Tesla magnetic resonance imaging of the anterior cruciate ligament of the knee: can we differentiate complete from partial tears? Skeletal Radiol 40(6):701–707

    Article  PubMed  Google Scholar 

  31. Steckel H, Vadala G, Davis D, Musahl V, Fu FH (2007) 3-T MR imaging of partial ACL tears: a cadaver study. Knee Surg Sports Traumatol Arthrosc 15(9):1066–1071

    Article  PubMed  Google Scholar 

  32. Noyes FR, Mooar LA, Moorman CT, McGinniss GH (1989) Partial tears of the anterior cruciate ligament: progression to complete ligament deficiency. J Bone Jt Surg Br 71(5):825–833

    Article  CAS  Google Scholar 

  33. Fritschy D, Panoussopoulos A, Wallensten R, Peter R (1997) Can we predict the outcome of a partial rupture of the anterior cruciate ligament? A prospective study of 43 cases. Knee Surg Sports Traumatol Arthrosc 5(1):2–5

    Article  CAS  PubMed  Google Scholar 

  34. Fayard JM, Sonnery-Cottet B, Vrgoc G, Oloughlin P, de Mont-Marin-Grade FB, Vieira TD, Thaunat M (2019) Incidence and risk factors for a partial anterior cruciate ligament tear progressing to a complete tear after nonoperative treatment in patients younger than 30 years. Orthop J Sports Med 7(7):2325967119856624

    Article  PubMed  PubMed Central  Google Scholar 

  35. Orchard J, Seward H, McGivern J, Hood S (2001) Intrinsic and extrinsic risk factors for anterior cruciate ligament injury in Australian footballers. Am J Sports Med 29:196–200

    Article  CAS  PubMed  Google Scholar 

  36. Ali N, Rouhi G, Robertson G (2013) Gender, vertical height and horizontal distance effects on single-leg landing kinematics: implications for risk of non-contact ACL injury. J Hum Kinet 37:27

    Article  PubMed  PubMed Central  Google Scholar 

  37. Steffensmeier AM, Lamont SM, Metoyer G, DiPaolo Z, Froehle AW (2020) Relationship between age at adult height and knee mechanics during a drop vertical jump in men. Orthop J Sports Med 8(8):2325967120944912

    Article  PubMed  PubMed Central  Google Scholar 

  38. Williams JG (1971) Aetiologic classification of sports injuries. Br J Sports Med 4:228–230

    Article  Google Scholar 

  39. Carulli C, Innocenti M, Roselli G, Sirleo L, Matassi F, Innocenti M (2020) Partial rupture of anterior cruciate ligament: preliminary experience of selective reconstruction. J Orthop Traumatol 21(1):1–9

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedics, Base Hospital, Guwahati, Assam, 781029, India

    S. K. Rai, T. P. Gupta & Amit Kale

  2. Department of Orthopedics, INHS Kalyani, Visakhapatnam, AP, 530005, India

    V. B. Singh

  3. Department of Radio Diagnosis, Base Hospital, Guwahati, Assam, 781029, India

    Vineet Vij

  4. Department of Trauma and Emergency, Base Hospital, Guwahati, Assam, 781029, India

    Omna Shaki

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  1. S. K. Rai
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Rai, S.K., Gupta, T.P., Singh, V.B. et al. Retrospective analysis and risk of progression of partial anterior cruciate ligament injuries in a young population. Arch Orthop Trauma Surg 143, 2063–2071 (2023). https://doi.org/10.1007/s00402-022-04519-w

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  • DOI: https://doi.org/10.1007/s00402-022-04519-w

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