title: Partial tears of anterior cruciate ligament: Results of single bundle augmentation.
abstract: BACKGROUND
  Partial tears of the anterior cruciate ligament (ACL) are common and usually present with symptomatic instability. The remnant fibers are usually removed and a traditional ACL reconstruction is done. But with increased understanding of ACL double bundle anatomy, the remnant tissue preservation along with a single bundle augmentation of the torn bundle is also suggested. The purpose of this study was to evaluate the results of selective anatomic augmentation of symptomatic partial ACL tears. Our hypothesis is that this selective augmentation of partial ACL tears could restore knee stability and function.
  
  
  METHODS
  Consecutive cases of 314 ACL reconstructions, 40 patients had intact ACL fibers in the location corresponding to the anteromedial (AM) or posterolateral (PL) bundle and were diagnosed as partial ACL tears perioperatively. All patients underwent selective augmentation of the torn bundle, while keeping the remaining fibers intact using autogenous hamstring graft. A total of 38 patients (28 males, 10 females) were available with a minimum of 3 years followup. 26 cases had AM bundle tears and 12 cases had PL bundle tears respectively. Patients were assessed with International Knee Documentation Committee (IKDC) 2000 Knee Evaluation Form, Lysholm score; instrumented knee testing was performed with the arthrometer (KT 2000). Statistical analysis was performed to compare the preoperative and postoperative objective evaluation.
  
  
  RESULTS
  At 3 years followup, 31.6% patients were graded A, 65.8% were graded B and 2.6% was graded C at IKDC objective evaluation. Manual laxity tests, Lysholm's score, mean side to side instrumental laxity and Tegner activity score improved significantly. 76% patients returned to preinjury level of sports activity after augmentation.
  
  
  CONCLUSIONS
  The results of anatomic single bundle augmentation in partial ACL tears are encouraging with excellent improvement in functional scores, side to side laxity and return to sports activity.
authors.affiliation: Department of Orthopedics, Maulana Azad Medical College, New Delhi, India.
authors.forename: Dhananjaya
authors.initials: D
authors.lastname: Sabat
authors.affiliation: Department of Orthopedics, Maulana Azad Medical College, New Delhi, India.
authors.forename: Vinod
authors.initials: V
authors.lastname: Kumar
keywords: Anterior cruciate ligament; Anteromedial bundle; anterior cruciate ligament reconstruction; cruciate ligament; partial anterior cruciate ligament tear; posterolateral bundle; selective augmentation