title: Surgical management of partial tears of the anterior cruciate ligament.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Campus Biomedico University of Rome, Via Alvaro del Portillo 200, Rome, Italy, r.papalia@unicampus.it.
authors.forename: Rocco
authors.initials: R
authors.lastname: Papalia
authors.forename: Francesco
authors.initials: F
authors.lastname: Franceschi
authors.forename: Biagio
authors.initials: B
authors.lastname: Zampogna
authors.forename: Andrea
authors.initials: A
authors.lastname: Tecame
authors.forename: Nicola
authors.initials: N
authors.lastname: Maffulli
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Denaro
mesh_terms: D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods; D006801:Humans; D007593:Joint Instability / Q000209:etiology / Q000601:surgery*; D007718:Knee Injuries / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D007719:Knee Joint / Q000601:surgery; D010808:Physical Examination; D011434:Proprioception; D012399:Rotation; D012421:Rupture / Q000601:surgery; D016896:Treatment Outcome