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Promising Short-Term Results Following Selective Bundle Reconstruction In Partial Anterior Cruciate Ligament Tears


Ferran Abat, MD, PhD
SPAIN

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Promising Short-Term Results Following Selective Bundle Reconstruction In Partial Anterior Cruciate Ligament Tears

Ferran Abat, MD, PhD, SPAIN Pablo E. Gelber, MD, PhD, SPAIN Juan Ignacio Erquicia, MD, SPAIN Marc Tey, MD, SPAIN Xavier Pelfort, PhD, SPAIN Raúl Torres-Claramunt, PhD, SPAIN Joan Carles Monllau, MD, PhD, Prof., SPAIN

ICATME-Institut Universitari Dexeus, Barcelona, Barcelona, SPAIN

2013 Congress   Paper Abstract   2013 Congress   Not yet rated

 

Anatomic Location

Knee

Anatomic Structure

Ligaments

Diagnosis / Condition

Instability Tears

Diagnosis Method

Physical Examination

Sports Medicine

Practice Management Outcome Studies

Treatment / Technique

Arthroscopy Autograft Double Bundle Repair / Reconstruction

Ligaments

ACL

Summary: Selective reconstruction of only the injured ACL bundle showed excellent functional results with normalized stability and with a return to the previous level of activity at a minimum 2 years’ follow-up and the arthroscopic examination was the most reliable tool for properly diagnosing a condition observed in almost 1 out of every 5 ACL reconstructed knee in this series.

Purpose

To assess the outcome of patients undergoing selective reconstruction of an injured bundle of isolated anteromedial bundle (AMB) or posterolateral bundle (PLB) tears at minimum 2 year’s follow-up.

Methods

A consecutive series of 147 ACL reconstructions was prospectively analyzed. Patients with partial ACL tears who underwent selective bundle reconstructions were studied. Stability was assessed with Lachman, anterior-drawer and Pivot-shift tests and KT-1000 evaluation. Functional assessment was performed with Lysholm and Tegner questionnaires. The preoperative MRI was analyzed to detect differences with the arthroscopic findings. Complications were recorded.

Results

Twenty-eight patients (19%) were included with a minimum follow-up of 25 months. Eighteen had AMB and 10 PBL tears. Only 19% of the MRI was categorized as partial ACL tears.
The Lysholm score improved from 66.1 and 65.5 to 96.6 and 95.2 in the AMB and PLB groups respectively (p<0.001). The same or only one level lower of the Tegner score was restored. Pivot-shift, Lachman and anterior drawer tests were negative at final follow-up in all cases (p < 0.001). Five reconstructed AMB developed extension loss including 2 due to Cyclops lesions. They all were resolved surgically.

Conclusions

Selective reconstruction of only the injured ACL bundle showed excellent functional results with normalized stability and with a return to the previous level of activity at a minimum 2 years’ follow-up. The arthroscopic examination was the most reliable tool for properly diagnosing a condition observed in almost 1 out of every 5 ACL reconstructed knee in this series.