Background: Injury to both cruciate ligaments and both posterior meniscus roots occurs in multiligamentous knee injuries; nonetheless, osseous avulsion-type injuries of these structures are rare. This study outlines the surgical technique for anatomically repairing these structures while preserving the surrounding cartilage fragments. Indications: Distal osseous avulsions of the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial and/or lateral meniscus posterior root tears (MMPRT and LMPRT). Technique Description: Arthroscopic primary repair of the ACL, PCL, MMPRT, and LMPRT is performed using a transtibial technique in a unique case of the combination of osseous avulsions of these 4 structures. Results: Primary repair of distal ACL and PCL osseous avulsions has been described, with overall encouraging results. ACL fixation leads to a negative Lachman in most cases, and PCL fixation leads to reliable posterior translation and an excellent return to sport, as reported in a recent systematic review. Outcomes of osseous root repairs in the literature are scarce, but are expected to be similar to those of meniscus tissue root tears, which have been shown to delay or prevent osteoarthritis and the need for knee arthroplasty compared with nonoperative treatment or meniscectomy. Discussion/Conclusion: Early arthroscopic treatment of these osseous avulsions enables surgeons to assess all concomitant injuries, to remove callus and healing tissue, and perform anatomic repairs of the avulsed ligaments and menisci. Anatomic repair has the potential to provide excellent results with low surgical morbidity and good outcomes. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
List et al. (Thu,) studied this question.