TAILIEUCHUNG - Balke et al. Journal of Orthopaedic Surgery and Research 2010, 5:11

Balke et al. Journal of Orthopaedic Surgery and Research 2010, 5:11 CASE REPORT Open Access Unilateral aplasia of both cruciate ligaments Maurice Balke1*, Jonas Mueller-Huebenthal2, Sven Shafizadeh1, Dennis Liem3, Juergen Hoeher4 Abstract Aplasia of both cruciate ligaments is a rare congenital disorder. A 28-year-old male presented with pain and the feeling of instability of his right knee after trauma. The provided MRI and previous arthroscopy reports did not indicate any abnormalities except cruciate ligament tears. He was referred to us for reconstruction of both cruciate ligaments. The patient again underwent arthroscopy which revealed a hypoplasia of the medial trochlea and an extremely narrow intercondylar. | Balke et al. Journal of Orthopaedic Surgery and Research 2010 5 11 http content 5 1 11 JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH CASE REPORT Open Access Unilateral aplasia of both cruciate ligaments Maurice Balke1 Jonas Mueller-Huebenthal2 Sven Shafizadeh1 Dennis Liem3 Juergen Hoeher4 Abstract Aplasia of both cruciate ligaments is a rare congenital disorder. A 28-year-old male presented with pain and the feeling of instability of his right knee after trauma. The provided MRI and previous arthroscopy reports did not indicate any abnormalities except cruciate ligament tears. He was referred to us for reconstruction of both cruciate ligaments. The patient again underwent arthroscopy which revealed a hypoplasia of the medial trochlea and an extremely narrow intercondylar notch. The tibia revealed a missing anterior cruciate ligament ACL footprint and a single bump with a complete coverage with articular cartilage. There was no room for an ACL graft. A posterior cruciate ligament could not be identified. The procedure was ended since a ligament reconstruction did not appear reasonable. A significant notch plasty if not a partial resection of the condyles would have been necessary to implant a ligament graft. It is most likely that this would not lead to good knee stability. If the surgeon would have retrieved the contralateral hamstrings at the beginning of the planned ligament reconstruction a significant damage would have occurred to the patient. Even in seemingly clear diagnostic findings the arthroscopic surgeon should take this rare abdnormality into consideration and be familiar with the respective radiological findings. We refer the abnormal finding of only one tibial spine to as the dromedar-sign as opposed to the two medial and a lateral tibial spines in a normal knee. This may be used as a hint for aplasia of the cruciate ligaments. Background Aplasia of the cruciate ligaments is a very rare congenital pathology which was first described

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