Introduction: recent studies showed the possibility of spontaneous ACL healing in acute lesion with proper treatment. The goal of our study was to analyze the functional outcome of partial ACL tears treated acutely with suture-repair combined with a bone marrow stimulation (BMS) technique (microperforation). We hypothesized that knee stability could be restored and good functional outcome could be obtained with a simple primary repair technique.
Methods: From January 2003 to January 2006, 22 patients (14 males and 8 females – mean age: 23 years) with partial ACL rupture underwent acute primary ACL repair with our technique.
Inclusion-exclusion criteria:
anterior instability (confirmed intraoperatively by an isolated ACL tear),
surgery performed within 3 weeks from injury
. No grade 4 chondral defect,
no associated pathologies except for meniscal lesion
will to undergo to the same rehabilitation protocol.
Parameters analyzed included the standard knee scales (IKDC, Noyes, Lysholm and Tegner), SANE Score, Knee Laxity Analysis and Deep Flexion Tests. In 6 cases, second look arthroscopy was performed. All patients underwent a post-operative MRI.
Results: All these patients were available for follow up at 3/6 and final follow up (average of 18 months). Scoring systems revealed: Lysholm 93% (74–100), Tegner 7 (6–9), Noyes 80% (60–100) and Subjective (SANE) 86,22% (60–100). IKDC score demonstrated 55% group A, 36% B, 4% C and 4% D. This last patient didn’t go back to his previous activity level because of subjective apprehension. The knee was stable. Pivot shift test was negative in all the cases. Side to side difference was less or equal to 2 mm in all of our patients.
Conclusion: Based on the preliminary results, primary ACL repair with BMS can lead to favourable results in acute partial ACL lesion. However, further prospective randomized studies are recommended at longer follow-up to validate these findings.
