Case Report

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

Table 2

Summary of published studies regarding the treatment of ACL aplasia.

AuthorPublication yearNumber of kneesDescription

Katz et al.19675ACL agenesis treated with autologous reconstruction with good operative outcomes in all cases.

Thomas et al.198512Congenital cruciate ligament agenesis: half of the patients were asymptomatic, while the other half admitted to their knee giving way more than once a week. All patients underwent arthroscopy, but no ACL reconstruction was performed.

Kaelin et al.19866Documentation of arthroscopy in six knees with ligamentous aplasia.

Dejour et al.19901Bilateral ligamentous aplasia treated bilaterally with surgery. There was no subjective instability. However, there was persistent pain in the second operated knee.

de Ponti et al.20011Bilateral ACL agenesis is associated with tibial or fibular dysplasia, subluxation, or dislocation of the patella, ligament hyperlaxity.

Gabos et al.20054Four patients who underwent tendon allograft ACL reconstructions. After a follow-up of 31 months, only one case of a 10-degree extension occurred. Laxity was clinically and subjectively improved in all patients, with a mean Lysholm score of 81.

Frikha et al.20058 knees in the same familyCongenital cruciate ligament agenesis is autosomal, dominant.

Steckel et al.20051Lateral discoid meniscus is associated with ACL aplasia.
Case of ACL and PCL absence treated with surgery.

Manner et al.200634Bilateral ACL agenesis is associated with proximal focal femoral deficiency, congenital talipes equinovarus, fibular hemimelia.

Knorr et al.20061Case of ACL agenesis and a hypoplastic medial meniscus treated with Clochville ACL reconstruction. At the 5-year follow-up, the patient was asymptomatic, with clinically improved stability.

Lee et al. 20061Case of ACL agenesis and a hypoplastic PCL treated with notchplasty and transtibial single-bundle ACL reconstruction. At the 6-month follow-up, improved clinical stability without range of motion restriction was observed.

Roth et al.20103Bilateral ACL agenesis is associated with agenesis or hypoplasia of the patella, hip dysplasia, or dislocation.

Bedoya et al.20141Case of ACL agenesis treated with surgery.
Bilateral ACL agenesis is associated with scoliosis.

Sonn and Caltoum20141Male monozygotic twins with symptomatic ACL agenesis. Both underwent ligament reconstruction with a patellar graft. At 32 postoperative months, both patients had good clinical knee stability.