Partial tears of the anterior cruciate ligament: diagnosis and treatment.

In sports medicine, diagnosis and treatment of partial tears of the anterior cruciate ligament (ACL) continue to be difficult. Partial tears of the ACL are common, representing 10% to 28% of all ACL tears. As our understanding of the anatomy of the native ACL improves, our accuracy in diagnosing these injuries increases. The advent of magnetic resonance imaging (MRI) and recognition of injury patterns have more clearly delineated the pathoanatomy in a majority of these cases. Natural history studies following patients with these injuries have demonstrated that fewer than 50% of patients return to their preinjury activity level. Several studies have also documented that progression to complete rupture is a common outcome for patients who want to return to an active lifestyle. Treatment options include conservative modalities (eg, activity modification, functional rehabilitation, functional bracing) and surgery (eg, thermal shrinkage of remaining ACL, complete reconstruction, newer techniques to augment or reconstruct the damaged portion of the native ligament). Studies comparing conservative treatments with more aggressive operative interventions are required to fully evaluate the efficacy of these treatments.