Arthroscopic treatment of a large lateral femoral notch in acute anterior cruciate ligament tear.
A 24-year-old professional soccer player suffered an acute anterior cruciate ligament tear associated with a radiologically evident impression fracture of the lateral femoral condyle, the so-called "lateral femoral notch sign". Following MRI validation of the injury with detection of an additional lateral meniscus tear, arthroscopy was carried out 3 days after the injury. Due to the extended impression of about 5 mm, arthroscopically assisted closed reduction of the depression fracture was performed. A 3.2 mm tunnel was drilled at the lateral femoral condyle in a supero-inferior direction using an ACL tibial guide and the depressed area could be restored using an elevator. The resulting subchondral bone defect in the femoral condyle was filled with freeze-dried human cancellous bone allograft. As a one-stage procedure ACL reconstruction was carried out using a hamstring tendon technique. At 1-year follow up the patient has returned to full sporting function, including playing soccer with a radiographically reduced lateral femoral notch sign.
Department of Traumatology and Sports Injuries, University Hospital of Salzburg, Muellner Hauptstrasse 48, 5020, Salzburg, Austria. m.tauber@salk.at
Mark
M
Tauber
Michael
M
Fox
Heiko
H
Koller
Helmut
H
Klampfer
Herbert
H
Resch
D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy; D016025:Bone Transplantation; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005269:Femur / Q000601:surgery*; D006801:Humans; D007718:Knee Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D020127:Recovery of Function; D012916:Soccer / Q000293:injuries; D013710:Tendons / Q000637:transplantation; D055815:Young Adult