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Congenital absence of the anterior cruciate ligament (ACL) is a rare condition that has been reported only occasionally with other anomalies such as congenital dislocation of the knee, congenital short femur and congenital absence of the menisci. The association of abnormalities in the development of the menisci, condyles and tibial epiphysis has been explained by embryological studies, because these structures develop from common mesenchymal tissue. We report the case of a 12-year-old boy with congenital absence of the anterior cruciate ligament; he was previously treated for a valgus knee in another hospital.Radiography and magnetic resonance imaging showed a congenital absence of the ACL and aplasia of the tibial spine. We preferred conservative treatment until the boy reaches the age of growth maturation, and we have delayed ACL reconstruction to after closure of the physis. The question that arises from this case and from the literature is what kind of treatment to do and when.

Congenital absence of the anterior cruciate ligament associated wih discoid meniscus