SELECTIVE BUNDLE RECONSTRUCTION IN PARTIAL ANTERIOR CRUCIATE LIGAMENT TEARS

Study Design: prospective non-randomized clinical study. Background Context:Diagnosis and treatment of partial ACL tear in young patients present a difficult challenge. It is based on clinical examination, radiological and MRI data, but the sure diagnosis is by arthroscopic probing that usually determine the type of partial tear. Saving ACL remnants during ACL reconstruction may have some biomechanical, vascular and proprioceptive advantages for the patient. First, ACL remnants may add biomechanical strength in the immediate post-operative period to the reconstruction, while the graft strength depends primarily on the fixation device. In this period, the augmentation may be protected by the intact remnantsand bundle and may allow accelerated rehabilitation and an earlier return to sports. Objective:This study will evaluate the effectiveness of diagnosis and treatment of partial ACL tear and identifies which bundle was torn AM or PL and selective reconstruction of torn bundle. Patients and Methods:Thirty patients with partial ACL tears were included in this prospective study. They wewe operated in ZagazigUniveristy Hospitals and followed up for two years. 22 of these patients underwnt isolated selective PL bundle reconstruction while preserving AM bundle remnant and 8 patients underwent an isolated AM budlereconstructio with preservin PL bundle remnant. All reconstructions were done using doupled or trippledsemitendnosis graft. In all cases the femoral side was fixed using endobutton (Smith and Nephew), while the tibial side was fixed using bioabsorbable interference screw We used Lysholm score andInternational Knee Documentation Committee (IKDC) to evaluate our results. Results:A significant improvement was detected in post-operative knee stability and Post-operative knee pain. Conclusion: Our study confirms that selective bundle reconstruction with preservation of the totnbundle restores knee stability and function. The clinical outcomes were statistically improved .