The tibial spines are the paired bony peaks of the intercondylar eminence — the medial and lateral tibial spines — that project superiorly between the femoral condyles. They are the attachment sites for the ACL (lateral spine) and PCL (posterior to the spines) and serve as bony reference points for intraoperative landmark identification.
Tibial spine fractures (avulsion of the intercondylar eminence) are the paediatric equivalent of ACL tears, occurring through open physis before the ligament fibres. Classified by Meyers and McKeever (I-III) based on displacement. Displaced spines require arthroscopic or open reduction and fixation to restore ACL tension. Adults may develop tibial spine osteophytes in OA that impinge in the notch and limit extension.
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