Arthroscopic Treatment of Concurrent Avulsion Fracture of Anterior and Posterior Cruciate Ligament with Suspension Device.

Introduction: Simultaneous avulsion fractures of the insertion of both cruciate ligaments of the knee are extremely uncommon lesions and their treatment remains difficult. The purpose of this paper is to show an arthroscopic repair technique of simultaneous tibial avulsion fracture of both cruciate ligaments of the knee such by using an adjustable length suspension device.

Case Report: A 25-year-oldmale patient was treated by arthroscopic reduction and fixation of both bony avulsion of cruciate ligaments of the knee with a sliding and adjustable length suspension device (ZipTight, Biomet, Warsaw, IN, USA). There were no post-operative complications appeared. At 18-month follow-up, the patient was conducting normal life, free of symptoms. At clinical examination, Lachman, anterior drawer, pivot shift, posterior drawer, and reverse pivot shift tests were negative. Range of motion was 130° flexion, presenting a slight 5° of extension deficit. The International Knee Documentation Committee score was 83.80 points. Lysholm scale was 85 points.

Conclusion: The described repair technique is able to provide stable fixation of bone fragments in the face of early fracture consolidation, as well as minimizing potential complications and surgical time.