Arthroscopic Suture Fixation in Femoral-Sided Avulsion Fracture of Anterior Cruciate Ligament

Abstract

A femoral-sided avulsion fracture of the anterior cruciate ligament (ACL) is a rare and challenging condition. Most reported cases have occurred in childhood or adolescence. Many techniques of ACL repair have been reported, and in recent years, techniques in arthroscopic surgery have been developed and have become ever more popular with orthopaedic surgeons. We created a technique of arthroscopic ACL repair with suture anchor fixation for a femoral-sided ACL avulsion fracture. This technique saves the natural ACL stump. It is available for cases in which creation of a tibial tunnel is not allowed. Moreover, it does not require a skin incision for fixation on the far femoral cortex and, therefore, does not require a second operation to remove the fixation device. The arthroscopic technique also has a good cosmetic outcome.

Anatomical Repair of a Femoral-Sided Avulsion Fracture of the Anterior Cruciate Ligament

“…In children, the strength of the ligaments is greater than that of the bone and the growth plate, making them prone to avulsion fracture injuries 1,3,5,6 . On the other hand, skeletally mature patients, too, may realize avulsion fracture injuries despite its extremely rare occurrence [15][16][17][18]20,21 .…”

“…Postsurgical therapy varies depending on the case, but a minimum of a 4-week casting or bracing with restricted weight bearing has been reported in many cases in the literature [2][3][4][6][7][8][10][11][12][13][14][15] . Nonetheless, neither ROM nor daily activities were limited, and the postoperative course was relatively good in most cases with the exception of leftover laxity of the ACL 2,[6][7][8]10,12 .…”

Fixation of femoral attachment: anterior cruciate ligament avulsion fracture with arthroscopy suture loop technique

“…ACL repair with suture anchor fixation was performed. Six months after surgery, physical examination showed negative Lachman test, anterior drawer and pivot shift test 14. Shah et al presented a 47-year-old-woman with femoral avulsion fracture of ACL with multiple fractures of the clavicle, tibial plateau and proximal fibula.…”