Femoral Avulsion of the Anterior Cruciate Ligament in a Multiligament Setting: A Unique Case

Anterior cruciate ligament (ACL) femoral avulsions are a rare entity mainly seen in children. We describe a unique case of a bony ACL avulsion with a medial collateral ligament (MCL) and lateral meniscus (LM) tear in a 37-year-old patient who sustained a two-wheeler accident. The ACL femoral avulsion was fixed arthroscopically using a Knee Scorpion and a FiberTape fixed over a suture disc on the lateral cortex. The MCL was repaired with an internal brace using a FiberTape and two SwiveLocks and the torn LM was repaired using all-inside sutures. At 2 years of follow-up, the fragment was united, knee range of motion was 0° to 130°, and Knee Society Score was 98. This is the first case report of a femoral avulsion of the ACL combined with an MCL injury and a meniscus tear where all three were repaired with a unique technique and good results were obtained.