HSS Journal

, Volume 7, Issue 2, pp 190–193

Arthroscopic Avulsion Repair of a Pediatric ACL with an Anomalous Primary Insertion into the Lateral Meniscus

  • Jason O. Toy
  • Brian T. Feeley
  • Lawrence V. Gulotta
  • Russell F. Warren
Case Report

DOI: 10.1007/s11420-011-9197-0

Cite this article as:
Toy, J.O., Feeley, B.T., Gulotta, L.V. et al. HSS Jrnl (2011) 7: 190. doi:10.1007/s11420-011-9197-0



Injury to the anterior cruciate ligament (ACL) in the pediatric population is becoming more common, with the majority of ruptures occurring at the tibial insertion site. However, to our knowledge, there are no reports of avulsion in which the primary ACL insertion site is the anterior lateral meniscal root.


We report a rare case of a pediatric ACL/anterior horn of the lateral meniscus avulsion, which was successfully repaired arthroscopically.


In this patient, neither a mid-substance tear, nor a tibial eminence fracture was noted. Instead, the patient avulsed the tibial insertion of the ACL from its small footprint, which included an extensive attachment to the lateral meniscus.


We believe this developmental anomaly may provide further support of the shared embryological origin between the ACL and menisci. In this case report, we review the literature on anterior cruciate ligament injury and repair in the pediatric population.


ACL repairmeniscus repairpediatric

Copyright information

© Hospital for Special Surgery 2011

Authors and Affiliations

  • Jason O. Toy
    • 2
  • Brian T. Feeley
    • 1
    • 3
  • Lawrence V. Gulotta
    • 1
  • Russell F. Warren
    • 1
  1. 1.Department of Orthopedic SurgeryHospital for Special SurgeryNew YorkUSA
  2. 2.School of MedicineCase Western Reserve UniversityClevelandUSA
  3. 3.Department of Orthopaedic SurgeryUniversity of California, San FranciscoSan FranciscoUSA