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),

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.

The aim of this study was to evaluate the efficacy of Hyalograft®-C, in a group of patients with full thickness patellofemoral defects.

Method: 32 patients treated with Hyalograft®-C for patellofemoral chondral lesions were evaluated. Average age was 30.5 yrs. with a mean follow-up period of 24 months. The defect area was 4.7 cm2 and the lesions were due to trauma (12 patients), malalignment (4) and osteochondritis dissecans (2). Eight patients had previous knee arthroscopy, 2 had patellar re-alignment, and 1 patient had lateral retinacular release. Subjective evaluation, ICRS-IKDC 2000 scores were used for final evaluation. Patients underwent MRI at 12 months, two patients had 2nd-look arthroscopy and biopsy. Student- T Test was used for statistical analysis.

Results: Significant improvement (p< 0.0001) with VAS scale and subjective evaluation using the ICRS scale was demonstrated. A statistically significant improvement was reported with IKDC scoring systems. MRI demonstrated almost normal cartilage in 70% of the cases with positive correlation to clinical outcomes. 2nd-look arthroscopies demonstrated good integration with the surrounding cartilage and biopsies were characterized as hyaline-like cartilage.

Conclusions: Hyalograft C is a viable option for treatment of patellofemoral cartilage lesions. Additional follow-up assessments will confirm the long-term durability of these results.