Post by Dr. med. Theodoros Zafeiris, MHCM

Case of the week: - 26 years old male, physically active (mountain biking, soccer) - Status post ACL reconstruction (semitendinosus) + partial lateral meniscectomy in 2017 - Acute Trauma: knee sprain 1 month ago - No problems at all after the surgery 2017. Patient was able to return to sports. Symptoms reappeared after the trauma one month ago - MRI: ACL re-rupture, medial and lateral meniscus tears, collateral ligaments and PCL intact - CT scan: tibial tunnel partial ossified (plateau) and widening approx. 10-11mm diameter, femoral tunnel widening approx. 7 mm, moderate gonarthrosis - X-ray: varus deformity of 5.9°, tibial slope 15.1°, mMPTA 85.8°, mLDFA 88.3° - Symptoms: lachman ++, pivot -, anterior drawer ++, dial -, no typical osteoarthritis complaints, no other rotatory istability What would be your approach? Single- or two-stage? Realignment/slope reduction? Graft? Michael Hantes Nifon Gkekas MD, MSc Prof. Dr. Mirco Herbort PD Dr. Ralph Akoto Wolf Petersen Andreas B. Imhoff Dr. med. Jan Vonhoegen Prof. Dr. med. Thomas Pfeiffer Prof. Dr. med. Daniel Günther, MHBA, FACS Wolfgang Zinser Prof. Dr. Matthias Feucht Dr. Christoph Werry Kristian Schneider Prof. Dr. med. Maurice Balke Prof. Dr. med. Andrea Achtnich, MHBA David H. DEJOUR Arne Venjakob Julian Messler Lars-Christoph Dr. Linke Emmanuel Papakostas Prof. Dr. med. Sven Scheffler Nikolaos Koukoulias Khalid AlKhelaifi Prof. Dr. Sepp Braun Κώστας Ιντζόγλου, MD, PhD Brian Cohen, MD Lasse Lempainen Amit Momaya Dr. Christian Fluck Philipp Schuster Dr. med. Christoph Offerhaus nicholas colyvas MD, FAAOS Dr. Christian Schoepp Geert Alexander BUIJZE, MD PhD FEBHS René El Attal Dr. med. Alexander Lages Dr. Hatim ALShareef Dr. Deepak Bhatia Philipp Niemeyer