Fully arthroscopic treatment of medial Hoffa fracture associated with anterior cruciate ligament tear: case report and surgical technique

A Hoffa fracture is a rare intra-articular injury consisting of a coronal plane fracture of one or both of the distal femoral condyles. Because of the rarity of medial Hoffa fractures, only a few reports have described this injury and its arthroscopic management. In this article, we present a rare case involving a 32-year-old man with a displaced medial Hoffa fracture associated with a proximal anterior cruciate ligament tear. He was treated by a single-stage fully all-inside arthroscopic technique. Arthroscopic-assisted internal fixation ensured fragment stability and enabled us to visualize the fracture reduction, monitor the screw insertion, and reconstruct the anterior cruciate ligament tear at the same time. This technique is a novel but demanding treatment method for medial Hoffa fractures and is particularly useful for properly selected patients with associated intra-articular knee injuries.

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Evaluation of medial meniscal injury and anterior cruciate ligament tear by MRI with arthroscopic correlation

International Surgery Journal ◽

10.18203/2349-2902.isj20170197 ◽

2017 ◽

Vol 4 (2) ◽

pp. 589

Author(s):

Chiranjib Murmu ◽

Pushpakant Tiwari ◽

Vijender Kumar Agrawal

Keyword(s):

Anterior Cruciate Ligament ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Sensitivity And Specificity ◽

Predictive Value ◽

Cruciate Ligament ◽

Knee Injuries ◽

Anterior Cruciate Ligament Tear ◽

Ligament Tear ◽

Anterior Cruciate

Background: Apart from clinical examination multiple modalities (conventional radiography, MRI and arthroscopy) are currently used to evaluate knee injuries. This study is intended to compare the sensitivity and specificity of MRI in correlation of arthroscopy in diagnosing of knee injuries.Methods: This is a prospective study involving 51 patients with history of knee injuries who were admitted in the Department of Orthopaedics, Command Hospital, Kolkata, India from April 2013 to June 2014. MRI of the knee joint was done for all these patients either before or after admission. The patients were then subjected to diagnostic and therapeutic arthroscopy. Statistical analysis was used to calculate the sensitivity, specificity, positive predictive value and the negative predictive value, in order to assess the reliability of the MRI results.Results: The sensitivity and specificity of MRI with respect to arthroscopy in anterior cruciate ligament tear is 87.5% and 66.6%. Positive predictive value is 87.5%. Negative predictive value is 66.6%. Accuracy is 81.82%. The sensitivity and specificity of MRI with respect to arthroscopy in medial meniscal tears is 85.7% and 70.8% respectively. Positive predictive value is 63%, negative predictive value is 89.4%, accuracy is 76.3%.Conclusions: The present study supports that MRI is helpful in diagnosing medial meniscal and anterior cruciate ligament injuries. The negative predictive value of a MRI was found to be high for all structures of the knee joint and hence a MRI can be used to exclude pathology, thus sparing patients from expensive and unnecessary surgery.

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