Revision Anterior Cruciate Ligament Reconstruction in an Adult Twin With Meier-Gorlin Syndrome

Background Meier-Gorlin syndrome is a rare autosomal recessive disorder characterized by the clinical triad of microtia, patellar aplasia or hypoplasia, and proportionate short stature. The absence of the patella poses 2 surgical challenges: lack of a donor site for graft harvest and lack of anterior restraint during anterior cruciate ligament (ACL) reconstruction surgery. Given that individuals with Meier-Gorlin syndrome generally exhibit normal cognitive function and life expectancy, ensuring knee stability is essential to support their ability to participate in sports and engage in daily activities independently. Case Report We present the case of an adult twin with Meier-Gorlin syndrome who had an absent patella and recurrent knee instability after ACL retear. At 2-year follow-up after revision ACL reconstruction, the patient9s Single Assessment Numeric Evaluation score had increased to 100 from a preoperative score of 30. The patient reported excellent pain relief and was able to perform all activities of daily living. Conclusion Successful revision ACL reconstruction is possible in a patient with Meier-Gorlin syndrome. However, these patients may be at higher risk of revision because of the lack of the anterior constraint provided by a normal extensor mechanism with a present patella.