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Arthroscopic double-loop crossover suture fixation for treatment of tibial eminence avulsion fractures
摘要
Background: Tibial eminence avulsion fracture are bony avulsions of the anterior cruciate ligaent (ACL) from its insertion on the tibial intercondylar eminence. These fractures are rare and are more commonly seen in children and adolescents than in adults. The main goal of treatment is anatomic reduction of avulsed fragment. To achieve this goal, one can choose open surgical reduction or arthroscopic reduction techniques. To minimize drawbacks of open surgery, arthroscopic reduction and internal fixation (ARIF) is recommended for displaced fractures. Purpose: To evaluate the clinical outcomes of arthroscopic treatment in tibial eminence avulsion fracture with a double-loop crossover suture technique. Methods: Between January 2009 and September 2013, a total of 14 patients with displaced tibial eminence avulsion fractures underwent arthroscopic reduction and fixation with double-loop crossover suture technique. The mean follow-up period was 26 months. Clinical outcome evaluation included plain radiographs, Lysholm knee score, Tegner activity scale, International Knee Documentation Committee (IKDC) score, Lachman test and KT-1000 arthrometer (MEDmetric, San Diego, CA). Results: All patients were followed up for 24 months (range, 24-28 months). The mean preoperative Lysholm score was 64.4 (range, 44-80), while the mean Lysholm score at final follow-up was 96.8 (range, 90-100). The mean preoperative Tegner activity scale was 3.2 ± 1.1 (range, 2-5) and was 6.4 ± 0.6 (range, 5-7) at final follow-up. The mean IKDC subjective score before treatment and final follow-up were 56.8 (range, 46-72.4) and 97 (range, 90-100), respectively. At final follow up, 14 patients (100%) were classified as normal or nearly normal (grade A or B) by IKDC score. Bony union were observed in all patients within 3 months. Furthermore, all patients were negative for the Lachman test and had ＜ 3mm side-to-side difference with the KT-1000 arthrometer. Conclusion: Arthroscopic treatment of tibial eminence avulsion fractures with double-loop crossover suture technique restored the stability of the joint, ensure proper bone healing and regain preinjury activity status.
延伸閱讀
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