Arthroscopic Reinsertion of an Anterior Cruciate Ligament Tibial Spine Fracture Avulsion With Double-Strand Lacing of Anterior and Posterior Bundles.

Peras, Matthieu; Stergiadou, Styliani; Restrepo Garcia, Inés; Sudaros, Valentin; Fairag, Rayan; Gonzalez, Jean-François; Micicoi, Grégoire · Arthrosc Tech · 2026

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Abstract

Avulsion fractures of the tibial spines have the same mechanism as anterior cruciate ligament ruptures but occur more often in subjects with an immature skeleton or in osteoporotic subjects. Displacement of more than 2 mm generally requires fixation. Several open or arthroscopic techniques have been described: from screwing of the spines to suturing of the anterior cruciate ligament. We describe in this technical note, with a video, a 4-strand suture in the 2 bundles of the anterior cruciate ligament under arthroscopy, allowing a more anatomical and stable fixation of the fracture, without placement of intraosseous material, which can be a good option in young patients.