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Current Concepts Review   |    
A Comprehensive Review of Partial Anterior Cruciate Ligament Tears
Michael J. DeFranco, MD1; Bernard R. BachJr., MD2
1 Harvard Shoulder Service, Massachusetts General Hospital, Yawkey Center for Outpatient Care, 3G, 55 Fruit Street, Boston, MA 02114
2 Midwest Orthopaedics at Rush, Division of Sports Medicine, Rush University Medical Center, 1725 West Harrison, Suite 1063, Chicago, IL 60612. E-mail address for B.R. Bach Jr.: brbachmd@comcast.net
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Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2009 Jan 01;91(1):198-208. doi: 10.2106/JBJS.H.00819
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Abstract

A partial tear of the anterior cruciate ligament is characterized by an asymmetric Lachman-test result, a negative pivot-shift test, a low-grade KT-1000 arthrometer measurement (=3 mm), and arthroscopic evidence of anterior cruciate ligament injury.

The pivot shift test is the most important test in determining anterior cruciate ligament insufficiency. A positive test, independent of the grade, is indicative of a functionally deficient anterior cruciate ligament.

Nonoperative management results in an acceptable clinical outcome in the majority of cases.

Progression to knee instability (anterior translation and rotation) depends on the extent of the anterior cruciate ligament injury and the activity level of the patient.

Thermal treatment is not recommended for partial tears of the anterior cruciate ligament.

Symptomatic instability is treated reliably with anterior cruciate ligament reconstruction.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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