Open Reduction of Lateral Femoral Condyle Impaction Fracture Using Autologous Bone Graft in the Setting of Anterior Cruciate Ligament Reconstruction With Bone-Patellar Tendon-Bone Autograft

Jorge Chahla; Jacob T Morgan; Napatpong Thamrongskulsiri; Jose F Vega; Gabriel Octavio Pérez Lloveras; Felipe Casanova; Robert F LaPrade

doi:10.1016/j.eats.2025.103854

Open Reduction of Lateral Femoral Condyle Impaction Fracture Using Autologous Bone Graft in the Setting of Anterior Cruciate Ligament Reconstruction With Bone-Patellar Tendon-Bone Autograft

Arthrosc Tech. 2025 Sep 2;14(11):103854. doi: 10.1016/j.eats.2025.103854. eCollection 2025 Nov.

Authors

Jorge Chahla^{1

2}, Jacob T Morgan^{1

2}, Napatpong Thamrongskulsiri³, Jose F Vega^{1

2}, Gabriel Octavio Pérez Lloveras⁴, Felipe Casanova^{1

2}, Robert F LaPrade⁵

Affiliations

¹ Division of Sports Medicine, Midwest Orthopaedics at Rush, Chicago, Illinois, U.S.A.
² Department of Orthopaedic Surgery, Rush University, Chicago, Illinois, U.S.A.
³ Sports Medicine Research Group, Faculty of Medicine, Chulalongkorn University, Pathumwan, Bangkok, Thailand.
⁴ Austral University Hospital, Provincia de Buenos Aires, Argentina.
⁵ Twin Cities Orthopedics, Edina, Minnesota, U.S.A.

Abstract

Lateral femoral condyle (LFC) impaction fractures are an increasingly recognized pathology occurring concomitantly with anterior cruciate ligament (ACL) rupture. These lesions are important to identify and treat because of the impact they have on knee instability, meniscal degeneration, a faster rate of progression to osteoarthritis, and increased chance of ACL graft rerupture. The technique presented is intended for use in large and deep LFC impaction fractures in conjunction with ACL reconstruction with bone-patellar tendon-bone autograft. It uses an open anterolateral arthrotomy and a subchondral cortical window to place autologous bone graft into the LFC from the bone-patellar tendon-bone tibial harvest site and tibial tunnel bone chips. This is performed to mitigate the risk of posttraumatic complications and to restore the native joint anatomy in a biologically sound, cost-effective manner.