| Summary: | Introduction: Anterior cruciate ligament agenesia is a very rare condition for which the treatment remains controversial. Most of the information that we have comes from case reports, and to our knowledge, this is the first case associated with both vertebral and meniscal malformation. Furthermore, surgical treatment was effective in this patient. Case report: We present a case of a 30-year-old Hispanic female patient with pain and instability following a direct trauma to the knee. She underwent an MRI, which showed absence of the anterior cruciate ligament. During the interview, she referred left limb shortening noticed first at 4 months old and lumbar scoliosis with bilateral prominent L5 transverse process diagnosed one year ago. Due to these findings, the diagnosis of agenesia of anterior cruciate ligament associated with vertebral malformation and ipsilateral femoral shortening was made. The patient was managed with arthroscopic autologous reconstruction of the anterior cruciate ligament and meniscal suture for the treatment of meniscus hypermobility that was diagnosed during the arthroscopic repair. At one-month follow-up, she was walking without assistance with a complete range of motion and no more complaints of instability and pain, and at for-months follow up she returned to her normal previous activity. Conclusion: Although anterior cruciate ligament agenesia is extremely rare, there are some conditions associated that may rise the suspicious of this, as in this case. And even though still controversial, this case shows the effectiveness of surgical treatment when the patient starts with symptoms of anterior knee instability, despite the absence of previous complaints before the triggering event.
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