Abstract
Antero-inferior reattachment of a femoral peel off type injury of the Anterior Cruciate Ligament (ACL) occurs fairly commonly when an injury involves a valgus strain in addition to the more common external rotation strain of the knee.
This produces a recognisable and consistent pattern of clinical signs with an increased Lachman but with a solid end stop, an increased anterior drawer with no end stop and a pivot glide or 1+ pivot shift. This pattern of signs can be explained on a biomechanical basis.
From a functional point of view the reattachment often provides enough stability to allow a patient to return to a reasonable level of sporting activity.
Problems arise however when functional instability does occur and an inability to interpret the clinical signs, an MRI that is often interpreted as normal, and an arthroscopy when, to the inexperienced, the ACL may look relatively normal, leads to an error in decision making with regard to ACL reconstruction.
This variety of ACL injury has not been previously reported.
The abstracts were prepared by Mr Roger Smith. Correspondence should be addressed to him at the British Association for Surgery of the Knee, c/o BOA, Royal College of Surgeons of England, 35–43 Lincoln’s Inn Fields, London WC2A 3PN.
