Arthroscopic Anterior Cruciate Ligament Avulsion Fixation With a Knotless Suture Anchor: A Minimalistic Approach

This technical note outlines a minimalist arthroscopic approach to anterior cruciate ligament avulsion fracture fixation using a bioabsorbable knotless suture anchor. This method represents a less invasive alternative to traditional techniques, catering specifically to fractures classified as Meyers and McKeever type II or III. The procedure is performed through standard anterolateral and anteromedial portals without the need for additional incisions or bone tunnel drilling, making it particularly suitable for children and adolescent patients with open physes. The technique involves the use of a suture hook to pass a double-stranded suture through the anterior cruciate ligament, anchored eccentrically to the anterior tibial incline with a knotless suture anchor. This approach allows for anatomic reduction with adjustable tension and without the potential risk of iatrogenic osteochondral injury. Nonetheless, it should be acknowledged that prospective biomechanical studies and larger patient samples are necessary to validate this technique compared with existing fixation methods.