title: Partial ACL reconstruction with preservation of the posterolateral bundle.
abstract: BACKGROUND
  Over the past decade, our understanding of the anterior cruciate ligament (ACL) has evolved considerably. Based on this knowledge, ACL reconstruction techniques have changed and selective reconstruction procedures have been developed for partial tears. Our hypothesis was that stability and function can be restored to the knee with selective bundle reconstruction of partial ACL tears and preservation of the residual fibers.
  
  
  METHODS
  This was a multicenter retrospective study of 168 partial reconstructions of the anteromedial (AM) bundle of the ACL with preservation of the posterolateral (PL) bundle. All patients underwent a clinical evaluation based on the objective and subjective IKDC scores and the Lysholm score after a mean follow-up of 26 months (12-59 months). Preoperative and postoperative instrumental measurement of knee laxity was performed by arthrometer and/or by (Telos(®)) stress radiography. Statistical analysis and comparison was performed between pre- and postoperative results.
  
  
  RESULTS
  The preoperative and postoperative subjective IKDC scores were 63.7 and 90.5 at the final follow-up respectively (P<0.001). The preoperative and postoperative Lysholm scores were 80 and 95.5 respectively (P<0.001). Preoperatively, most patients were classified C on the objective IKDC score. At the final follow-up 92% of the patients were classified A or B (P<0.001). Differential preoperative laxity was 5.5mm (range: 0-14 mm) and 1.1mm (range: 0-4mm) at the final follow-up (P<0.00001).
  
  
  CONCLUSIONS
  Our study confirms that selective reconstruction of the AM bundle of the ACL with preservation of the PL bundle restores stability and function to the knee. Special attention should be paid to the size of the graft used to avoid excess tissue in the intercondylar notch.
authors.affiliation: Centre orthopédique Paul-Santy, 24, avenue Paul-Santy, 69008 Lyon, France. sonnerycottet@aol.com
authors.forename: B
authors.initials: B
authors.lastname: Sonnery-Cottet
authors.forename: J-C
authors.initials: JC
authors.lastname: Panisset
authors.forename: P
authors.initials: P
authors.lastname: Colombet
authors.forename: T
authors.initials: T
authors.lastname: Cucurulo
authors.forename: N
authors.initials: N
authors.lastname: Graveleau
authors.forename: C
authors.initials: C
authors.lastname: Hulet
authors.forename: J-F
authors.initials: JF
authors.lastname: Potel
authors.forename: E
authors.initials: E
authors.lastname: Servien
authors.forename: C
authors.initials: C
authors.lastname: Trojani
authors.forename: P
authors.initials: P
authors.lastname: Djian
authors.forename: N
authors.initials: N
authors.lastname: Pujol
mesh_terms: D000293:Adolescent; D000328:Adult; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult