Editorial Commentary: Increased Tibial Slope and Decreased Medial Proximal Tibial Angle Negatively Affect Anterior Cruciate Ligament Graft Maturation: Objective Evidence on When to Add a Lateral Extra-Articular Augmentation Procedure to a Soft-Tissue Ante

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Disclosures The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: C.M.L. reports speaking and lecture fees from Foundation Medical and Evolution Surgical and has a family member that reports relationships with Ossur Americas, Smith & Nephew, Linvatec Europe, and Responsive Arthroscopy that include consulting or advisory; a family member that reports relationships with Ossur Americas, Smith & Nephew, Arthroscopy Association of North America, and American Orthopaedic Society for Sports Medicine that include funding grants. R.F.L. reports consulting or advisory for Ossur Americas, Smith & Nephew, Linvatec Europe, and Responsive Arthroscopy; and funding grants from Ossur Americas, Smith & Nephew, Arthroscopy Association of North America, and American Orthopaedic Society for Sports Medicine. The other author (L.V.T.) declares that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. 4. Knee Surg Sports Traumatol Arthrosc. 2022 Jan;30(1):71-77. doi: 10.1007/s00167-021-06515-w. Epub 2021 Mar 1. Two-fragment Segond fracture validates historical descriptions of independent soft tissue attachments. Byrne KJ(1), Rothrauff BB(1), Nagai K(1)(2), Onishi K(1), Fu FH(3). Author information: (1)Department of Orthopaedic Surgery, School of Medicine, University of Pittsburgh, Kaufmann Medical Building, Suite 1011, 3471 Fifth Avenue, Pittsburgh, PA, 15213, USA. (2)Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. (3)Department of Orthopaedic Surgery, School of Medicine, University of Pittsburgh, Kaufmann Medical Building, Suite 1011, 3471 Fifth Avenue, Pittsburgh, PA, 15213, USA. ffu@upmc.edu. This is a case report of a 26-year-old male who sustained a Segond fracture in the context of an acute anterior cruciate ligament (ACL) rupture incurred while downhill skiing. Further work-up revealed that the Segond fracture consisted of two distinct fragments with separate soft tissue attachments, including the capsule-osseous layer of the iliotibial band and the short arm of the biceps femoris. Imaging showed interval healing of the Segond fracture between initial presentation and the performance of arthroscopic ACL reconstruction approximately 4 months later. As intraoperative evaluation demonstrated that anatomic ACL reconstruction restored translational and rotatory knee stability, surgical repair of the Segond fracture, or the anterolateral complex of the knee more broadly, was not required. Maintenance of translational and rotatory knee stability was confirmed at serial post-operative appointments up through final follow-up.Level of evidence Level V. © 2021. European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA). DOI: 10.1007/s00167-021-06515-w