Selective bundle reconstruction for partial anterior cruciate ligament tears: High return to sport, excellent long-term stability and function at 6-year follow-up.

Purpose: Partial anterior cruciate ligament (ACL) tears account for 10%-27% of all ACL injuries. As an alternative to the well-established option of complete reconstruction, selective bundle augmentation has recently been introduced into the repertoire of reconstruction techniques, aiming to preserve remnant tissue and provide superior biological and functional outcomes. The objective of our study is to assess long-term clinical results, complication rates and return to sport after arthroscopic selective bundle reconstruction in patients with partial ACL tears. Methods: A retrospective cohort study was conducted. Patients with symptomatic partial ACL tears undergoing arthroscopic selective bundle reconstruction were included. Clinical stability and functional outcomes were assessed using anterior drawer, Lachman, pivot shift, Lysholm, Tegner scales, and a patient satisfaction score based on the Musculoskeletal Outcomes Data Evaluation and Management System scale. Statistical analyses were performed as described. Results: There was a statistically significant improvement in all stability tests after surgery (p < 0.001). The mean Lysholm score increased from 72.3 to 95.3, and the Tegner activity level from 2.05 to 4.86 (both p < 0.001). A high rate of return to sport was achieved with a low complication and re-injury rate at long-term follow-up. Conclusions: Arthroscopic selective bundle reconstruction is a safe and effective treatment for partial ACL tears, providing excellent long-term stability, functional recovery and patient satisfaction, with low complication and re-injury rates. These findings support remnant-preserving techniques in selected patients, though further prospective comparative studies are warranted. Level of Evidence: Level III.