Partial Tears of the ACL

One of the dilemmas facing the sports physician is treatment of the partial tear of the anterior cruciate ligament. The definition of a partial tear is a history of injury to the anterior cruciate ligament, a positive Lachman test with a firm end point, a negative pivot-shift test, KT-1000 side-to-side difference of <5mm, and arthroscopic evidence of injury to the anterior cruciate ligament.

The natural history of the partial tear is controversial. Reports suggest that both conservative and operative treatment offer good results. Noyes and his colleagues had a 50% incidence of instability in high-demand sports participation athletes who had an anterior cruciate ligament tear of more than 50%. They also had a 75% incidence of reinjury. This suggests that patients in high-demand sports require reconstruction. Freunsgaard and Johnannsen had good results with conservative treatment in patients who avoided high-demand athletics, and Buckley and colleagues reported that the degree of anterior cruciate tear did not correlate with outcome. Only half of their patients were able to resume their previous level of sports activity.

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