Document Detail

Natural history of partial anterior cruciate ligament tears: a systematic literature review.
MedLine Citation:
PMID:  23153663     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Partial anterior cruciate ligament (ACL) tear is frequent, and indications for surgery may be raised by a diagnostic aspect associating slight laxity with no clear pivot-shift. Unlike that of complete ACL tear, the natural history of partial tear remains controversial.
MATERIAL AND METHOD: A systematic literature review searched for referenced publications on the natural history of partial ACL tear. Twelve specific articles were retrieved. Initial diagnosis was systematically confirmed on arthroscopy, without ACL surgery. The following criteria were analyzed: firstly, preoperative: confirmation of inclusion criteria, preoperative clinical data, follow-up, arthroscopic lesion assessment, Lachman test, Pivot shift test, hemarthrosis, associated lesions and secondly, follow-up: Lachman test, Pivot shift test, revision surgery, functional clinical scores, pain, sport and return to sport, meniscal events.
RESULTS: Preoperatively, Lachman tests were positive (soft or delayed) in a mean 49.7% of cases (range, 0-100%); pivot shift test was systematically negative. At a mean 5.2 years' follow-up, Lachman test was "positive" in 47.6% of cases (range, 38-59%), with positive pivot shift test in 26.3% (range, 5-51%). 54.3% patients reported pain (range, 36-64%), and mean Lysholm score was 88.4 (17-100%). Fifty-two percent (21-60%) of patients resumed sport at their previous level.
DISCUSSION/CONCLUSION: The natural history of non-operated partial ACL tear is good over the medium term, especially if patients limit their sports activities. The greater the functional instability, the more frequent is residual pain. Laxity, although not quantified, seems to progress with time, with a positive pivot shift test emerging in a quarter of cases. Functional management may be recommended in non-athletic patients without meniscal lesion, but surgical treatment may be recommended in other patients. Indications for ACL reconstruction are thus the same in partial as in complete tear.
N Pujol; P Colombet; T Cucurulo; N Graveleau; C Hulet; J-C Panisset; J-F Potel; E Servien; B Sonnery-Cottet; C Trojani; P Djian;
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Publication Detail:
Type:  Journal Article; Review     Date:  2012-11-13
Journal Detail:
Title:  Orthopaedics & traumatology, surgery & research : OTSR     Volume:  98     ISSN:  1877-0568     ISO Abbreviation:  Orthop Traumatol Surg Res     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-26     Completed Date:  2013-05-13     Revised Date:  2013-10-31    
Medline Journal Info:
Nlm Unique ID:  101494830     Medline TA:  Orthop Traumatol Surg Res     Country:  France    
Other Details:
Languages:  eng     Pagination:  S160-4     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Masson SAS. All rights reserved.
Versailles Hospital Center, Orthopedics Department, Versailles-Saint-Quentin University, 177, Rue de Versailles, 78157 Le Chesnay, France.
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MeSH Terms
Anterior Cruciate Ligament / injuries*
Wounds and Injuries / diagnosis

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