Case Report

HSS Journal

, Volume 7, Issue 2, pp 190-193

First online:

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

  • Jason O. ToyAffiliated withSchool of Medicine, Case Western Reserve University Email author 
  • , Brian T. FeeleyAffiliated withDepartment of Orthopedic Surgery, Hospital for Special SurgeryDepartment of Orthopaedic Surgery, University of California, San Francisco
  • , Lawrence V. GulottaAffiliated withDepartment of Orthopedic Surgery, Hospital for Special Surgery
  • , Russell F. WarrenAffiliated withDepartment of Orthopedic Surgery, Hospital for Special Surgery

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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 repair meniscus repair pediatric