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Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-01-2014 | Knee

Surgical management of partial tears of the anterior cruciate ligament

Authors: Rocco Papalia, Francesco Franceschi, Biagio Zampogna, Andrea Tecame, Nicola Maffulli, Vincenzo Denaro

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 1/2014

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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Title: Surgical management of partial tears of the anterior cruciate ligament
Authors: Rocco Papalia
Francesco Franceschi
Biagio Zampogna
Andrea Tecame
Nicola Maffulli
Vincenzo Denaro
Publication date: 01-01-2014
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 1/2014
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-012-2339-1

At a glance: The STEP trials

Springer Medicine

Surgical management of partial tears of the anterior cruciate ligament

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

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