Arthroscopic Anterior-Row Fixation for Anterior Cruciate Ligament Avulsion Injuries

Anterior cruciate ligament avulsion fractures are more commonly seen in children with open physes than in adults. Arthroscopic fixation is considered the gold standard in the management of such injuries. Our technique of anterior-row fixation for these injuries provides various advantages in the form of physeal-sparing, complete anatomic reduction with no anterior beaking, no arthrofibrosis, no residual instability, no intra-articular hardware, no need for a second operation to remove implants, and finally, a full range of movement with no loss of extension. Compared with other methods of fixation, our technique uses no tunnels; requires only 3 portals; yields no iatrogenic cartilage or meniscal injury; uses a single implant (anterior-row anchor); and is bone sparing, economical, and simple.