title: Partial tears of the anterior cruciate ligament.
abstract: Partial anterior cruciate ligament (ACL) tears were first described nearly fifty years ago but the optimal treatment for these injuries continues to be a subject of considerable debate. A question remains whether it is advantageous to preserve the ACL remnant and augment it with a graft, or to debride it and proceed with a standard ACL reconstruction unhindered by remnant fibers in the notch. Clinical outcomes of bundle preserving surgery are promising. An increasingly large body of scientific evidence suggests that augmenting the intact bundle is beneficial in terms of vascularity, proprioception and kinematics. With this knowledge, a number of surgeons have developed techniques to augment the intact bundle of the ACL in partial tears and to biologically enhance standard reconstruction techniques by preserving the ACL remnant. Correct tunnel placement is critical for achieving successful short and long-term outcomes after ACL reconstruction. However, published studies have several limitations including a limited number of patients and lack of control groups for direct comparison of outcomes. Concerns continue to exist with respect to an increased risk of impingement following augmentation, responsible of cyclops syndrome. The objective of this article was to outline the diagnostic approach, describe a reproducible and simple surgical procedure that allows correct femoral tunnel placement without the need for aggressive notch debridement and report the clinical outcome of partial ACL reconstruction.
authors.affiliation: Générale de santé, hôpital privé Jean-Mermoz, centre orthopédique Santy, 24, avenue Paul-Santy, 69008 Lyon, France. Electronic address: sonnerycottet@aol.com.
authors.forename: B
authors.initials: B
authors.lastname: Sonnery-Cottet
authors.affiliation: Clinique du Sport, 2, rue Negrevergne, 33700 Merignac, France.
authors.forename: P
authors.initials: P
authors.lastname: Colombet
mesh_terms: D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D001696:Biomechanical Phenomena; D006801:Humans; D011434:Proprioception; D012421:Rupture / Q000601:surgery
keywords: Anterior cruciate ligament; Anteromedial bundle; Partial rupture; Posterolateral bundle; Selective bundle reconstruction