Presentation
Right knee pain and swelling. Skiing injury on 2 months prior. No prior surgery
Patient Data
The ACL is oedematous and laxed with complete disruption of the proximal fibres compatible with acute full-thickness tear. Distal anterior fibres are retracted and flipped into the anterior intercondylar notch, which may block full knee extension. The PCL is intact.
There are focal subchondral fractures of peripheral weightbearing aspect of lateral femoral condyle and posterior aspect of the lateral tibial plateau. There is associated moderate bone marrow oedema. Additional severe marrow oedema and possible small cortical avulsion fracture of medial tibial eminence.
There is a moderate joint effusion. While the LCL is intact, there is moderate-severe periligamentous soft tissue oedema.
Case Discussion
This is a case of a full-thickness ACL tear with several subchondral fractures. The patient was scheduled with an orthopaedic surgeon to discuss operative repair.
Co-author:
Michael Cooley, MD
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