LIVRE JDG 2016

CONSERVATIVE TREATMENT AFTER PARTIAL ACL TEAR: IS RETURN TO SPORT POSSIBLE?

231

In order to analyse the development of meniscal

tears, we studied a homogeneous population

without any associated lesion. Fifty seven

percents of the patients who progressed to a

complete tear presented associated meniscal

lesions. We didn’t report any cartilage lesion

but our follow-up was short. Young patients

presenting meniscal and/or cartilage lesion

have a greater risk to develop early osteo

arthritis. Considering this point of view,

patients presenting a risk to progress to a total

tear should be initially identified and a surgical

treatment should be proposed. Conservative

treatment including rehabilitation and

progressive return to sport can be proposed for

the less active patients.

CONCLUSION

Non operative treatment for partial ACL tears

can be carefully proposed to young and active

patients. A lower level of sport than before the

partial tear is usually reported.

Patient motivation to return to sport should be

precisely analysed. Identifying patients’ risk

for progression to anterior cruciate ligament

deficiency is a critical step in developing the

treatment strategy. Surgical treatment should

be proposed to patients who desire to return to

pivoting sports at the same level. If a

conservative treatment is decided, return to

sport should be progressive and patients should

be informed of the risk of progression to a

complete rupture and the development of

associated meniscal lesions.

A longer follow-up is mandatory to analyse the

development of meniscal and chondral lesions

in the group which did not progress to a total

tear.

LITERATURE

[1] VAN DYCK P, DE SMET E, VERYSER J,

LAMBRECHT V, GIELEN JL, VANHOENACKER FM,

& al.

Partial tear of the anterior cruciate ligament of the

knee: injury patterns on MR imaging.

Knee Surg Sports

Traumatol Arthrosc Off J ESSKA 2012; 20(2): 256-61.

[2] ABAT F, GELBER PE, ERQUICIA JI, PELFORT X,

TEY M, MONLLAU JC. Promising short-term results

following selective bundle reconstruction in partial anterior

cruciate ligament tears.

The Knee 2013; 20(5): 332-8.

[3] AMIS AA, DAWKINS GP. Functional anatomy of the

anterior cruciate ligament. Fibre bundle actions related to

ligament replacements and injuries.

J Bone Joint Surg Br

1991; 73(2): 260-7.

[4] DEFRANCO MJ, BACH BR. A comprehensive review

of partial anterior cruciate ligament tears.

J Bone Joint Surg

Am 2009; 91(1): 198-208.

[5] TEMPONI EF, DE CARVALHO JÚNIOR LH,

SONNERY-COTTET B, CHAMBAT P. Partial tearing of the

anterior cruciate ligament: diagnosis and treatment.

Rev Bras

Ortop 2015; 50(1): 9-15.

[6] COLOMBET P, DEJOUR D, PANISSET JC, SIEBOLD

rench

rthroscopy

ociety

. Current concept of partial

anterior cruciate ligament ruptures.

Orthop Traumatol Surg

Res OTSR 2010; 96(8 Suppl): S109-18.

[7] DEJOUR D, NTAGIOPOULOS PG, SAGGIN PR,

PANISSET JC. The diagnostic value of clinical tests,

magnetic resonance imaging, and instrumented laxity in the

differentiation of complete versus partial anterior cruciate

ligament tears.

Arthrosc J Arthrosc Relat Surg Off Publ

Arthrosc Assoc N Am Int Arthrosc Assoc 2013; 29(3): 491-9.

[8] ODENSTEN M, LYSHOLM J, GILLQUIST J. The

course of partial anterior cruciate ligament ruptures.

J Sports Med 1985; 13(3): 183-6.

[9] SOMMERLATH K, ODENSTEN M, LYSHOLM J. The

late course of acute partial anterior cruciate ligament tears. A

nine to 15-year follow-up evaluation.

Clin Orthop 1992;

(281): 152-8.

[10] NOYES FR, MOOAR LA, MOORMAN CT,

McGINNISS GH. Partial tears of the anterior cruciate

ligament. Progression to complete ligament deficiency.

J Bone Joint Surg Br 1989; 71(5): 825-33.

[11] BARRACK RL, BUCKLEY SL, BRUCKNER JD,

KNEISL JS, ALEXANDER AH. Partial versus complete

acute anterior cruciate ligament tears. The results of

nonoperative treatment.

J Bone Joint Surg Br 1990; 72(4):

622-4.

[12] BAK K, SCAVENIUS M, HANSEN S, NØRRING K,

JENSEN KH, JØRGENSEN U. Isolated partial rupture of

the anterior cruciate ligament. Long-term follow-up of

56 cases.

Knee Surg Sports Traumatol Arthrosc Off J ESSKA

1997; 5(2): 66-71.

[13]

FRITSCHY

PANOUSSOPOULOS

WALLENSTEN R, PETER R. 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 Off J ESSKA 1997; 5(1): 2-5.