Conservatively Treated Tears of the Anterior Cruciate Ligament. Long-term Results

Forty-nine patients who had a complete tear and forty-one who had a partial tear of the anterior cruciate ligament were examined as regards long-term healing. All had had a positive clinical diagnosis just after the injury, which was confirmed in the majority under anesthesia, at arthrotomy, on arthroscopy, or with a combination of these methods. The re-examination was performed an average of eight years after the injury. Besides a functional and objective evaluation, radiographic examination and evaluations of isokinetic and isometric strength were made. The multidimensional analysis revealed that in an unselected population the long-term results of the complete tears were poor, because of chronic instability. In many, reconstructive operations were needed, and post-traumatic arthritis was common. In the patients who had a partial tear, the results were quite good even if the stability of the knees had not improved when compared with the initial post-traumatic status. Conservative treatment of complete tears of the anterior cruciate ligament cannot be recommended as a treatment of choice, whereas partial tears can be treated by non-operative methods.