Arthroscopic Avulsion Repair of a Pediatric ACL with an Anomalous Primary Insertion into the Lateral Meniscus

Abstract

Background

Injury to the anterior cruciate ligament (ACL) in the pediatric population is becoming more common, with the majority of ruptures occurring at the tibial insertion site. However, to our knowledge, there are no reports of avulsion in which the primary ACL insertion site is the anterior lateral meniscal root.

Methods

We report a rare case of a pediatric ACL/anterior horn of the lateral meniscus avulsion, which was successfully repaired arthroscopically.

Results

In this patient, neither a mid-substance tear, nor a tibial eminence fracture was noted. Instead, the patient avulsed the tibial insertion of the ACL from its small footprint, which included an extensive attachment to the lateral meniscus.

Conclusions

We believe this developmental anomaly may provide further support of the shared embryological origin between the ACL and menisci. In this case report, we review the literature on anterior cruciate ligament injury and repair in the pediatric population.