77 years old obese gentleman who underwent bilateral knee replacement (left in 2016 and right in 2018) fell at home and sustained injury to right knee and right ankle 2 months ago. He was treated with plate osteosynthesis for fracture right distal tibia and knee injury was managed conservatively. Patient came to us with pain and instability of right knee. On clinical examination the knee was unstable and dislocatable. Preoperartive X-Ray was showed avulsion fracture of medial condyle of femur. At surgery the whole medial collateral ligament had avulsed along with the medial condyle making the knee unstable.
We repaired MCL avulsion using suture anchor and ethibond. Constrained spacer was used for additional stability . Post operative X-Ray shows perfectly balanced knee with suture anchor in situ. Patient is now able to bear full weight with the help of knee brace and we have allowed range of motion exercises.