Congenital aplasia of the anterior cruciate ligament

Abstract

A seven-year-old girl, whose right knee gave way, was found to have anterolateral instability of the joint associated with congenital aplasia of the anterior cruciate ligament. Instability was present in the final 30 degrees of extension, and has been controlled by a brace which prevented this movement.

Knee Reconstruction in Syndromes With Congenital Absence of the Anterior Cruciate Ligament

“…Congenital ACL absence is uncommon and has been reported as an isolated anomaly 2,11,25 or as part of a syndrome complex. These syndromes include congenital short femur, 13,14,16 proximal femoral focal deficiency, 31 fibular hemimelia, 3,13,31 congenital knee dislocation, 6,18 Larsen syndrome, 20 and absence of the radius.…”

“…3,6,9,13,14,16,31 The majority of reports describe patients as having no complaints of knee instability with daily activities, 2,13,16,24,29,31 however, episodes of swelling and frequent giving way are also reported. 11,24,31 Other studies indicate only a ''modest loss of function,'' 11 with patients ''adapting to their knee instability,'' 16 thus postulating that ACL reconstruction would be unwarranted. These studies are unified by a lack of standardized tests of knee function, description of activity level, and patient follow-up.…”

“…3,6,9,13,14,16,31 While several reports describe patients with no complaints of functional instability with daily activities, 2,13,16,24,29,31 thus advocating nonoperative treatment, episodes of swelling and frequent giving way are also reported. 11,24,31 Reconstruction of the ACL in patients with congenital ACL deficiency has received only scant mention in the literature, 16,18 with no reported follow-up.…”

“…C ongenital absence of the anterior cruciate ligament (ACL) has been reported as an isolated anomaly 2,11,25 or as part of a syndrome complex. 3,6,9,13,14,16,18,[20][21][22][23]28,31,32 Studies involving congenital syndromes in which ACL deficiency is a common finding have focused mainly on correction of angular deformity, limb lengthening, or amputation and prosthetic fitting, with almost no mention of treatment of instability from the ACL deficiency.…”

Surgical Treatment of a Rare Isolated Bilateral Agenesis of Anterior and Posterior Cruciate Ligaments

“…Generally, the malformation is unilateral [9–17], more rarely bilateral [5, 6, 14, 18]. In the literature most of the cases described showed that this condition is usually associated with other abnormalities of the musculoskeletal system, in particular of the lower limb such as agenesis of the menisci [19]; tibial spines [20]; agenesis or dysplasia of the patella, tibia, and fibula [11, 12, 18, 21, 22]; focal defects of the proximal femur [17, 22, 23] and multiple organ syndromes like thrombocytopenia-absent radius syndrome (TAR) [24, 25] and arthrogryposis [26]. A congenital defect of one or both cruciate ligaments determines well-defined morphological alterations of both the intercondylar notch and tibial spines, as can be seen upon radiographic examination of the “tunnel view” and the MRI [2, 13, 16, 17, 20, 22, 27].…”