Surgical treatment of partial anterior cruciate ligament lesions: medium-term results

Purpose: this study was conducted to evaluate subjective and objective clinical outcomes of partial reconstruction of the anterior cruciate ligament (ACL) in comparison with complete ACL reconstruction. Methods: three groups, each comprising 20 patients, were evaluated at a minimum follow-up of 12 months. The group 1 patients underwent partial ACL reconstruction, while those in group 2 and group 3 underwent complete ACL reconstruction, performed using either bone-patellar tendon-bone (BPTB) or quadrupled hamstring tendon (HT) grafts, respectively. The subjective outcome was evaluated using the Lysholm knee scale and the subjective International Knee Documentation Committee (IKDC) scoring system. A visual analog scale (VAS) was used for pain assessment and sporting activity was rated using the Tegner activity scale. Objective evaluation was performed using the IKDC objective form, KT-1000 arthrometer and KiRA triaxial accelerometer. Results: at the follow-up evaluation, the mean subjective IKDC score was 86.1±10.3 in group 1, 85.2±11.1 in group 2, and 82.7±7.8 in group 3. The Lysholm score was 91.3±7.3 in group 1, 91.7±9.6 in group 2, and 89.4±6.1 in group 3. KT-1000 tests showed a mean side-to-side difference of 1.1 mm ± 1.5 mm (range, 0-5 mm) in group 1; 0.79 mm ± 0.8 mm (range, 0-2mm) in group 2; and 1.45 mm ± 1 mm (range, 0-3 mm) in group 3. The differences between groups were not statistically significant. Conclusions: both subjective and objective outcomes of partial ACL reconstruction were comparable to those of complete reconstruction, but partial reconstruction in the presence of a partial lesion of the ACL is considered by the authors to be more respectful of the native vascularization, innervation and anatomy of the ACL, conferring an advantage in terms of recovery of the complete function of the knee. Level of evidence: Level III, retrospective comparative study.