title: Arthroscopic decompression and notchplasty for long-standing anterior cruciate ligament impingement in a patient with multiple epiphyseal dysplasia: a case report.
abstract: BACKGROUND
  Multiple epiphyseal dysplasia is a genetically and clinically heterogeneous osteochondroplasia with symmetrical involvement. It is characterized by joint pain in childhood and early adulthood with early onset of osteoarthritis, mainly affecting the hips.
  
  
  METHODS
  We report the case of a 20-year-old man of Asian origin with multiple epiphyseal dysplasia presenting with bilateral knee pain, stiffness and instability found to be caused by bilateral anterior cruciate ligament impingement on abnormal medial femoral condyles. Bilateral staged arthroscopic notchplasty was performed successfully, resulting in subjective relief of pain, and improved range of movement and stability.
  
  
  CONCLUSIONS
  Care should be taken not to exclude a diagnosis of multiple epiphyseal dysplasia when few of the characteristic radiographic features are evident but clinical suspicion is high. This case highlights the scope for subjective symptomatic improvement following a minimum of surgical intervention. We recommend limiting early intervention to managing symptomatic features rather than radiographic abnormalities alone.
authors.affiliation: Trauma and Orthopaedics, Kingston Hospital, Surrey, UK. trehanravi@hotmail.com
authors.forename: R K
authors.initials: RK
authors.lastname: Trehan
authors.forename: N
authors.initials: N
authors.lastname: Dabbas
authors.forename: D
authors.initials: D
authors.lastname: Allwood
authors.forename: M
authors.initials: M
authors.lastname: Agarwal
authors.forename: C
authors.initials: C
authors.lastname: Kinmont