Knee · Tendons, fractures & replacement
Tibial spine fracture fixation
Tibial Spine (ACL Avulsion) Fracture
The condition
The ACL attaches to a bump of bone in the center of the shin bone, the tibial spine. In children and some adults, a fall or twist can pull this piece of bone off rather than tearing the ligament. This causes pain, swelling, trouble straightening the knee, and instability. It is functionally similar to an ACL tear.
The surgery
This is an outpatient surgery done through small incisions with a camera. The bone fragment is put back in place and held with strong sutures or a screw, re-tightening the ACL. A trapped meniscus is freed, and in growing children the growth plates are protected. The final plan is determined during surgery.
Recovery at a glance
- Weight-bearing
- Full weight as tolerated with crutches; the brace is locked straight for walking and sleep for 6 weeks.
- Motion
- Bending to 45° for 2 weeks, then pushed: 90° by 4 weeks and 120° by 6 weeks. Regaining motion early is a priority.
- Daily life
- School or desk work often within 1–2 weeks; no PE or sports until cleared. No driving while taking narcotic pain medication.
- Running
- Typically 12–14 weeks, once strength allows.
- Sports
- No sooner than ~5 months; typically 5–6 months, after strength and hop testing.
A general guide. Your restrictions and timeline may change based on what is found and done at surgery.
Risks & benefits
Benefits: Most patients regain a stable knee and return to sports. Risks are uncommon and include infection, blood clots, loss of motion (the most common issue; may need another procedure), the fragment not healing, hardware irritation that may require removal, injury to nearby structures (such as nerves, blood vessels, or cartilage), stiffness, persistent pain, and the need for further surgery. These will be reviewed with you in detail before surgery.
Patient Surgical Information
Open, save or print. Bring your questions to your pre-op visit.
Before & after every surgery