The intercondylar eminence is the bony ridge dividing the medial and lateral tibial plateaus, consisting of medial and lateral intercondylar tubercles (tibial spines). The ACL attaches to the anterior intercondylar area just anterior to the medial tubercle, and the PCL attaches to the posterior intercondylar area. The anterior and posterior meniscal horns anchor in the intercondylar region around these structures.
| Articulations |
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| Landmarks |
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| Ossification | Part of the proximal tibial epiphysis, which ossifies from a centre present around birth and fuses with the shaft at about 16-18 years; in children it is partly cartilaginous, which explains avulsion fractures in this group. |
Intercondylar eminence (tibial spine) avulsion fractures are the paediatric equivalent of ACL tears, mainly in children aged about 8 to 14, where the incompletely ossified eminence fails before the ACL fibres. They are classified by Meyers and McKeever according to displacement. Non-displaced and some hinged fractures can be treated by haemarthrosis aspiration and immobilisation near extension, while displaced fractures require arthroscopic reduction and suture or screw fixation; adults with this injury usually need fixation. ACL reconstruction tunnels are placed in precise relationship to the eminence, with the tibial tunnel in the ACL footprint just anterior to the PCL. In osteoarthritis, sharpening and osteophytes of the tibial spines are common radiographic findings and can impinge in the femoral notch.
A paediatric equivalent of ACL rupture, mainly at age 8-14, where the ACL avulses its bony tibial spine attachment rather than tearing the ligament substance, producing a haemarthrosis and positive Lachman test; managed by arthroscopic reduction and suture or screw fixation for displaced fragments.
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