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Case Reports in Orthopedics
Volume 2017, Article ID 1636578, 8 pages
Case Report

Review and Long-Term Outcomes of Cruciate Ligament Reconstruction versus Conservative Treatment in Siblings with Congenital Anterior Cruciate Ligament Aplasia

1Clinic of Orthopedic Surgery, Kantonsspital Fribourg, Chemin des Pensionnats 2-6, 1708 Fribourg, Switzerland
2Department of Orthopaedics, Balgrist University Hospital, Forchstrasse 340, 8008 Zürich, Switzerland

Correspondence should be addressed to Diego Davanzo; hc.niweulb@oznavadogeid

Received 17 November 2016; Revised 12 March 2017; Accepted 19 April 2017; Published 14 May 2017

Academic Editor: Dimitrios S. Karataglis

Copyright © 2017 Diego Davanzo et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


There is no consensus on the best treatment for anterior cruciate ligament hypoplasia or aplasia. To our knowledge, no comparative study between operative and conservative treatment of this condition has ever been performed. Conservative treatment is a viable alternative to surgery for ACL aplasia. Two siblings were examined at our outpatient clinic. The male patient underwent bilateral ACL reconstruction, while his sister was treated conservatively. Our results show a worse long-term outcome for the operative patient. At her last follow-up, the female patient treated conservatively showed subjective improvement in stability and gait. A review of the literature shows inconsistent outcomes after reconstruction in contrast to reports with cruciate ligament agenesis that did not undergo reconstruction with acceptable to good outcomes. Cruciate reconstruction should be reserved for cases of impaired articular instability, objectively manifest in the frequency of giving-way episodes. Treatment depends on the patient’s condition and expectations. Surgery should therefore only be suggested after proper patient counseling.