Untreated acute anterior cruciate ligament tears of the knee: progression and the influence of associated injuries.

Abstract

Arthroscopy was performed on 53 consecutive patients with acutely torn ACL within two weeks after the initial injury. Arthrography was performed on 42 of the 53 patients prior to arthroscopy. Four Segond's fractures, twenty-six meniscus tears (eight medial, eighteen lateral) and nineteen medial collateral ligament (MCL) ruptures were revealed. One medial meniscectomy was performed under arthroscopy, and ten MCL tears were repaired in the acute phase. No surgical procedure was done on the torn ACL, but three excisions of ACL stubs were performed due to a restriction of full extension. The patients were re-examined clinically and radiographically after a period of from 3 years 7 months to 11 years 1 month, averaging 6 years 2 months. Four late meniscectomies were performed on the medial menisci in the chronic phase. Anterior translations of the tibia and knee rating scores of the patients with MCL tears and with Segond's fractures did not differ from those of the others. Anterior translations of the tibia in patients with medial meniscectomies increased (P < 0.05), and their functional scores significantly decreased (P < 0.01) more than those of the other patients. Patients with repaired MCL tears showed significantly higher functional scores than those of the patients with unrepaired MCL ruptures (P < 0.05).