Summary

The purpose of this study is to identify the incidence and the characteristics of partial ACL tears and their associated knee lesions in athletes.

Abstract

Introduction

Partial tears of the ACL are not rare injuries. There is not a universally accepted definition for these injuries, so the prognosis of a partial ACL tear is controversial and is dependent on the extent of the partial tear and associated meniscal, ligamentous, and osteochondral injuries. Unfortunately, the exact tear is very often unidentified because of the findings in both clinical examination and MRI, so eventually arthroscopic evaluation is necessary for the final confirmation.
The purpose of this study is to identify the incidence and the characteristics of partial ACL tears and their associated knee lesions in athletes.

Methods

In a prospective clinical study all the arthroscopic knee procedures, during the years 2010-2023, were recorded. As partial ACL tear we define the isolated rupture of either the anteromedial (AM) or posterolateral (PL) bundle in “probe test”. Associated lesions such as meniscus, chondral or other ligament injuries and other factors as age, gender, sports activity and clinical outcome were also recorded. Statistical analysis is performed.

Results

From 851 ACL ruptures in athletes 78 were partial ACL tears (9.2%). Soccer (65.3%), basketball (10.8%) and ski (7.5%) are the most common sport activities associated with an ACL injury in our study. There is no difference according to sport activity between partial and complete ACL tears. The posterolateral bundle (PL) is more commonly injured than anteromedial bundle (78% vs 22%). 30.8% of partial versus 17.7% of complete ACL ruptures are isolated injuries. The most common associated injuries in both groups are medial meniscus (57.4% vs 65.6%), lateral meniscus (48.1% vs 56.3%) and chondral lesions (24% vs 35.8%). There is no difference among males and females between partial and complete ACL ruptures (90% vs 10%). Instability is the main reason for operation especially for the partial ACL group (71.8% vs 42.7%). The ACL reconstruction with augmentation technique is the operative treatment of choice in these cases. The clinical outcome is better for the partial ACL reconstructed knees (96% vs 92% good or excellent results).

Discussion

Partial ACL tears in athletes are relative common injuries. Posterolateral (PL) bundle isolated ruptures, that leads to rotational instability, seems to occur much more often than AM bundle ruptures. A high percentage of these ruptures is associated with other structural knee injuries and this fact plays a significant role for the prognosis for these, difficult identified, injuries if they don’t be treated surgically.