2017 ISAKOS Biennial Congress IFOSMA ePoster #5044

 

Arthroscopic Treatment of A PCL Avulsion Fracture With The Use of Suspensory Fixation using two tibial tunnels and a posterior trans-septal portal

Chang Liu, Cangzhou, Hebei CHINA
Cangzhou Central Hospital, cangzhou, hebei, china

FDA Status Not Applicable

Summary

Avulsion fracture of the posterior cruciate ligament (PCL) on the tibial side is not a common condition. PCL avulsion fractures have been repaired with open reduction and internal fixation. Posterior approach is widely used for open repair, but it hard to detect and manage the associated intraarticular injuries of the knee.

Abstract

Purpose

This study examined the clinical outcomes of the suspensory fixation on management of PCL avulsion fractures using two tibial tunnels and a posterior trans-septal portal.

Methods

From January 2013 to June 2016, 18 patients with PCL avulsion fracture were included. 10 cases were treated by open methods (group I) and 8 cases were reduced and fixed arthroscopically (group II). In group II, two tibial bone tunnels were created using the PCL reconstruction guide, aiming at the medial and lateral borders of the tibial bed. The Endobutton device was used to stabilize the fracture. The sutures were passed through the tibial tunnels and tied over the cortical bridge between the openings of the tunnels to secure the fixation. The patients were followed-up for a mean of 7.3 months (6 to 12). Knee function before surgery and at last follow-up was evaluated by Lysholm scores, range of motion (ROM) and satisfactory of cosmetic (MBSRQ-AE).

Results

No complications were recorded, and all the two groups of patients returned to their usual daily activities. Mean postoperative Lysholm (P > 0.05) and ROM (P > 0.05) scores showed no significant difference between group I and group II. MBSRQ-AE score of group II was higher than group I (P < 0.05).

Conclusion

Arthroscopic Treatment of A PCL Avulsion Fracture With The Use of Suspensory Fixation using two tibial tunnels and a posterior trans-septal portal offers sufficient compression, restores the length of posterior cruciate ligament and can fix avulsion fragments of any size.