1 Principles top

Choice of fixation technique
Suturing is the best alternative to screw fixation if the avulsion fragment is small or comminuted.
Avulsion of anterior cruciate ligament is most often seen in the younger patient.
2 Patient preparation top

This procedure is normally performed with the patient in a supine position.
4 Reduction top

Ball-spiked pusher
The fracture is visualized with the arthroscope and reduction is attempted with a hook or another instrument inserted through another portal.

Clamps
In open procedures, the avulsed bony fragment of the intercondylar eminence is addressed directly and may be reduced with the help of clamps or wires.