Healing potential of the anterior cruciate ligament in terms of fiber continuity after a complete rupture: A systematic review

J Bodyw Mov Ther. 2021 Oct:28:246-254. doi: 10.1016/j.jbmt.2021.06.003. Epub 2021 Jun 12.


Introduction: Complete rupture of the anterior cruciate ligament is a major problem owing to inadequate surgery outcomes and the limited healing capacity of the ligament. This study aimed to summarise the evidence on the spontaneous healing potential of the anterior cruciate ligament in terms of fiber continuity based on magnetic resonance imaging (MRI) findings.

Methods: PubMed, Cochrane Library, Scopus, and MEDLINE databases were searched from their inception to November 1, 2020. Studies that analysed patients diagnosed with complete anterior cruciate ligament rupture were included. Further, studies that used conservative treatment as intervention and MRI finding as an outcome measure were included.

Results: In total, 9 studies, with a total of 734 participants, met the inclusion criteria. Knee laxity was measured in all studies. Two studies classified patients according to rupture location, where most ligaments with restored fiber continuity had proximal ruptures. All included studies reported spontaneous healing. Furthermore, none of the included studies reported the absence of healing.

Conclusions: This systematic review demonstrates the intrinsic healing capacity of the anterior cruciate ligament, indicating a higher healing potential for proximal ruptures. While our study reveals an emerging need to question general practice, a definitive conclusion could not be drawn owing to the low quality of the studies included and the heterogeneity of results.

Keywords: Anterior cruciate ligament; Intrinsic healing capacity; Magnetic resonance imaging; Rupture; Spontaneous healing; Systematic review.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Anterior Cruciate Ligament
  • Anterior Cruciate Ligament Injuries*
  • Anterior Cruciate Ligament Reconstruction*
  • Humans
  • Knee Joint / surgery
  • Rupture / surgery