Arthroscopic suture bridge fixation technique with multiple crossover ties for posterior cruciate ligament tibial avulsion fracture.

PURPOSE: This study examined the clinical outcomes of a newly developed technique, arthroscopic suture bridge fixation with crossover ties of PCL tibial avulsion fracture using two tibial tunnels and a posterior trans-septal portal.

METHODS

Records were reviewed of 18 patients (median age 33.5 years, range 13-55 years) with PCL tibial avulsion fractures treated with an arthroscopic suture bridge technique. Knee function before surgery and at last follow-up was evaluated by Lysholm and Tegner scores. A KT-2000 arthrometer was used to evaluate knee stability, and fracture union was assessed by plain radiographs.

RESULTS

Mean postoperative Lysholm (P < 0.001) and Tegner (P = 0.011) scores showed significant improvements compared with preoperative scores. Arthrometry showed that the mean side-to-side difference improved significantly, from 7.8 ± 0.8 mm preoperatively to 3 ± 1.2 mm postoperatively (P = 0.012). Radiographic evaluation showed solid union at the fracture site in all 18 patients at last follow-up.

CONCLUSION

This new arthroscopic double-tunnel pull-out suture bridge fixation with multiple crossover ties and posterior trans-septal technique for PCL tibial avulsion fracture yielded good clinico-radiological outcomes, including satisfactory stability and fracture site healing. This technique can be a useful treatment option for PCL tibial avulsion fracture even with small comminuted fracture due to compression by the unique crossover configuration mesh of multiple fixation sutures.

LEVEL OF EVIDENCE: IV.