Selective bundle reconstruction for partial anterior cruciate ligament injuries: One-year follow-up of a prospective case series
TL;DR
With ACL augmentation for partial tears, at 1-year follow-up, the selected patients experienced favorable functional improvements, suggesting the technique not only restored knee stability but also preserved patients’ knee function.
Abstract
Managing incomplete anterior cruciate ligament (ACL) injuries is difficult due to the ongoing debate on whether conservative management or surgical reconstruction is the best option. Augmentation surgery is an emerging technique that may help preserve the ligament’s proprioception and biological healing. This study aimed to examine the clinical and functional outcomes of ACL augmentation surgery in patients with symptomatic partial ligament injuries over 1 year. Between 2023 and 2024, a prospective analysis was conducted on 37 patients who underwent arthroscopically confirmed ACL augmentation for partial tears. The primary outcome measure was the International Knee Documentation Committee (IKDC) score. Secondary outcomes included Lysholm scores and IKDC clinical stability tests. Clinical and functional evaluations were performed preoperatively and at several standardized postoperative intervals. Notably, 9 patients (24.3%) required concomitant surgery for additional intra-articular pathologies identified during the procedure. One-year post-operative follow-up, 91.9% of the patients satisfied the IKDC criteria for success and 94.6% of the patients achieved the Lysholm criteria. Mean IKDC score was 83.1 preoperatively, 73.8 at 6 months postoperatively, and 80.5 at 1 year postoperatively ( p = 0.078). Lysholm scores were 96.7% preoperatively, 89.2% at 6 months postoperatively, and 96.4% 1 year postoperatively ( p = 0.856). A significantly higher score was achieved at the 1-year follow-up than at the 6-month follow-up, indicating high satisfaction. Almost two-thirds of patients achieved excellent functional recovery, with 48.6% of patients achieving the maximum IKDC score. With ACL augmentation for partial tears, at 1-year follow-up, the selected patients experienced favorable functional improvements. The technique not only restored knee stability but also preserved patients’ knee function. Longer follow-up studies are needed to determine whether these results are sustainable.