Arthroscopic treatment of anterior cruciate ligament avulsion.

A new technique is described for arthroscopic reduction and internal fixation (ARIF) of avulsion fractures involving the insertion of the anterior cruciate ligament (ACL). Conventional methods of treatment of ACL avulsion in adults may lead to suboptimal results owing to stiffness from either prolonged immobilization or the morbidity of arthrotomy. Contemporary techniques of arthroscopic reduction and percutaneous pinning do not achieve rigid fixation and thus still require cast immobilization. The placement of cannulated screws through the anteromedial arthroscopic portal provides rigid fixation while avoiding arthrotomy, allowing early mobilization and return to activity. The possibility of interstitial damage to the ACL and implications regarding tensioning of the ligament are considered A typical case illustrates ARIF of ACL avulsion. The technique minimizes morbidity and optimizes function.