Arthroscopic treatment of tibial spine malunion with ACL reconstruction: A case report

Abstract

Tibial spine fractures are rare and highly associated with instability of the knee as it is where the anterior cruciate ligament attaches. Malunion or nonunion are common complication of tibial spine fractures with loss of knee extension as the major problem. We report a case of a 30-year-old female with a neglected malunion tibial spine avulsion fracture of the right knee joint. She came to our clinic with knee pain and loss of extension due to malunion with impingement anteriorly of the tibial spine on the notch, which previously managed as osteoarthritis and planned for replacement in another hospital. We performed tibial spine excision, sacrificed the ACL remnants, and reconstructed it with hamstring tendons per arthroscopic. Post-operatively, the patient was able to fully extend the knee without any pain and instability. In this report, we present an alternative method regarding the treatment for malunion of tibial spine fractures.