By Robert E. Hunter
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Additional info for AANA Advanced Arthroscopy. The Knee
With moderate to severe infrapatellar entrapment, the patient will usually develop a shelf sign, FIGURE 4-4 Anterior patellar tilt (arrow). which denotes loss of the retropatellar tendon bursa and adherence of the patellar tendon to the tibia (Fig. 4-5). Diagnostic Imaging A standard series of radiographs should be taken on initial evaluation of the stiff knee. Weight- bearing anteroposterior and 45-degree anteroposterior flexion views should be obtained to assess for any degenerative changes. Bilateral 30-degree lateral views should be obtained to evaluate for any degenerative changes as well as any patella baja.
Additionally, with regard to intercondylar eminence avulsion fracture pathoanatomy, the anterior cruciate ligament (ACL) distal attachment is the midpoint of the tibial intercondylar eminence. Obviously, tibial intercondylar eminence fractures result in effective disruption of the ACL. 1,2 Tibial plateau fractures are common in sports, particularly in skiers. Avulsion fractures commonly occur in children and adolescents, with 50% caused by a fall from a bicycle. However, it is sometimes misunderstood that this condition occurs only in the young.
1984;15:236-238. Zaricznyj B. Avulsion fracture of the tibial eminence treated by open reduction and pinning. J Bone Joint Surg Am. 1997;59:1111-1114. Hunter RE, Willis JA. Arthroscopic fixation of avulsion fractures of the tibial eminence: technique and outcome. Arthroscopy. 2004;20:113-121. Caspari RB, Hutton PM, Whipple TL, Meyers JF. The role of arthroscopy in the management of tibial plateau fractures. Arthroscopy. 1985; 1:76-82. 10. 11. 12. 13. 14. 27 Jennings JE. Arthroscopic management of tibial plateau fractures.