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Tibial Spine Avulsion Repair
Dr. James Chen, M.D. - In San Francisco, CA

An arthroscopic procedure performed to repair a fracture of the tibial spine where the ACL inserts. Two small incisions are made on the front of the knee. An arthroscopic camera and instruments are used to tie sutures around the ACL. Tunnels are drilled through the bony tibial spine fragment and through the tibia. Sutures are passed through the tunnels and then secured on the tibia with absorbable anchors through another small incision made just below the knee.


Dr. Chen's surgical technique for arthroscopic tibial spine avulsion repair has been featured in Arthroscopy Techniques - The Journal of Arthroscopic and Related Surgery.

Arthroscopic Reduction of Tibial Spine Avulsion: Suture Lever Reduction Technique

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Common Questions about Tibial Spine Avulsion Repair

What is a tibial spine avulsion?

The tibial spine is where the ACL inserts on the tibia. In a hyperextension injury the bony insertion of the tibial spine can break or avulse. It is similar to an ACL tear except that it involves the bony insertion of the ACL.

When should I have tibial spine avulsion surgery?

When the tibial spine avulsion is displaced and there is clinical instability of the knee it should be surgically repaired.

How is it repaired?

Sutures are placed into the ACL ligament. Holes are drilled through the tibia and tibial fracture piece through which the sutures are threaded. The fracture is then reduced into its anatomic position and then the sutures are fixated with plastic anchors into the tibia.

What is the rehabilitation after tibial spine avulsion repair?

The fracture takes 8 weeks to heal during which the patient uses crutches. Physical therapy is performed for 2 to 3 months before return to full activity.

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Post-Operative MRI showing anatomic healed avulsion fracture in coronal view:


Post-Operative MRI showing anatomic healed avulsion fracture in sagittal view: