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Outpatient-based diagnostic criteria for partial ACL injury: clinical outcomes of non-operative treatment and radiographic predictor

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

This study aimed to (1) evaluate the short-term clinical outcomes of patients who underwent non-operative treatment for partial anterior cruciate ligament (ACL) tears diagnosed using the outpatient-based diagnostic criteria and (2) investigate the radiographic predictors distinguishing patients at risk of non-operative treatment failure.

Methods

From 2010 to 2019, patients diagnosed with partial ACL tears and treated with non-operative treatment were reviewed retrospectively. Patients were then classified into two groups: those who successfully responded to non-operative treatment (group S) and those who failed to respond to non-operative treatment and required surgical reconstruction within 6 months after injury (group F). ACL laxity, patient-reported outcomes (PROs), and several radiographic parameters were analyzed. To identify radiographic predictors related to clinical outcomes, radiographic parameters were compared between the groups, which were statistically matched for potential confounders (age and activity level) using inverse probability of treatment weighting.

Results

A total of 44 patients were analyzed (mean age, 28.7 ± 8.7 years; 31 men), and classified into two groups (group S, 23 patients; group F, 21 patients). There were no significant differences in ACL laxity and PROs between the groups at 1 year after either non-operative treatment or surgical reconstruction. A comparison of radiographic parameters between the groups revealed significant differences in several parameters related to secondary signs of ACL injury. Subsequent regression analyses revealed that anterior tibial translation and extent of bone bruises were radiographic predictors related to clinical outcomes.

Conclusion

Non-operative treatment for partial ACL tears diagnosed using the outpatient-based diagnostic criteria can provide successful short-term clinical outcomes in selective patients. Secondary signs of ACL injuries, particularly the amount of anterior tibial translation and the extent of bone bruises, are radiographic predictors that could differentiate patients at risk of non-operative treatment failure.

Level of evidence

Retrospective cohort study, III.

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Acknowledgements

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Funding

Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. There were no external sources of funding and none of the authors had any conflicts of interest.

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Authors and Affiliations

  1. Arthroscopy and Joint Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea

    Hyun-Soo Moon, Chong-Hyuk Choi, Je-Hyun Yoo, Min Jung, Hyuk-Jun Kwon & Sung-Hwan Kim

  2. Department of Orthopedic Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea

    Hyun-Soo Moon & Je-Hyun Yoo

  3. Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea

    Chong-Hyuk Choi, Min Jung & Yong-Jae Hong

  4. Department of Radiology, Gangnam Severance Hospital, Research Institute of Radiological Science, Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Republic of Korea

    Sungjun Kim

  5. Department of Orthopedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea

    Hyuk-Jun Kwon & Sung-Hwan Kim

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  1. Hyun-Soo Moon
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Correspondence to Sung-Hwan Kim.

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This study was ethically approved by the institutional review board from Gangnam Severance hospital (ID Number: 3–2020-0375).

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Moon, HS., Choi, CH., Kim, S. et al. Outpatient-based diagnostic criteria for partial ACL injury: clinical outcomes of non-operative treatment and radiographic predictor. Arch Orthop Trauma Surg 143, 2027–2036 (2023). https://doi.org/10.1007/s00402-022-04467-5

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