Anterior menisco-femoral ligaments combined with agenesis of the anterior cruciate ligament

Abstract

Introduction. The given article describes a rare case of congenital anomaly in the knee joint. It also analyzes the current state of art on such malformations and options for their treatment. The authors present their rationale on selecting a curative modality. The described developmental anomaly included the following: no tibial attachment of anterior horns of both meniscus, agenesis of the anterior cruciate ligament as well as of anterolateral and anteromedial meniscofemoral ligaments which were joined into a structure mimicking the track of native anterior cruciate ligament and attaching the femur lateral condyle in the projection of intercondylar ridge.Material and methods. Based on examination findings as well as on known curative options for similar anomalies, the researchers decided to perform the anchor stabilization of anterior horns of both menisci. Since there are no data on this type of knee surgery, the surgeons decided to make anchor stabilization similar to that which is used for the capsulolabral complex in case of instability of the shoulder joint. Surgical stages: stitching the anterior horns of both menisci, formation of bone channels in the projection of the proper anatomical attachment of the anterior horns to tibia condyles , their installation and fixation to the system of suture anchors.Results. The chosen curative modality has shown good clinical results during 12-month clinical observation.Conclusions. For the first time, the authors have described such combination of anomalies and variants of its correction. As it has been noted, MRI and clinical findings may contradict each other and create a false picture of the presence of anterior cruciate ligament and meniscus injury. For better differentiation of such anomalies, it is recommended to perform additional axial MRI protocols with the increased number of images.