Arthroscopic Suture Fixation of Tibial Eminence Avulsion Fractures

This report describes a novel arthroscopic technique for the treatment of anterior cruciate ligament (ACL) tibial eminence avulsion fractures. A 16-year-old boy who was diagnosed with a left ACL tibial eminence avulsion fracture was treated by arthroscopic fixation. Two bone tunnels were created from the anterior tibial cortex into the fracture bed, and a strong suture passed through the ACL just above its insertion was pulled out through them for reduction and fixation. A retrograde cannulated screw fixation was added for stronger fixation. Weight-bearing and range of motion exercises were started immediately after surgery. Radiographically, bone union was obtained 6 months postoperatively. During second-look arthroscopy (24 months postoperatively), there was no loss of reduction and no subsequent meniscal or cartilage injuries. At that point, the Lysholm score was 95, and the International Knee Documentation Committee score was 96.

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Editorial Commentary: Anterior Cruciate Ligament Tibial Eminence Avulsion Fractures: Are They Trying to Tell Us Something?

Arthroscopy The Journal of Arthroscopic and Related Surgery ◽

10.1016/j.arthro.2019.02.007 ◽

2019 ◽

Vol 35 (5) ◽

pp. 1545-1546

Author(s):

Brian B. Gilmer

Keyword(s):

Anterior Cruciate Ligament ◽

Cruciate Ligament ◽

Avulsion Fractures ◽

Editorial Commentary ◽

Tibial Eminence ◽

Anterior Cruciate

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Arthroscopic Suture Fixation for Avulsion Fractures in the Tibial Attachment of the Posterior Cruciate Ligament

Arthroscopy The Journal of Arthroscopic and Related Surgery ◽

10.1016/j.arthro.2012.04.141 ◽

2012 ◽

Vol 28 (10) ◽

pp. 1454-1463 ◽

Cited By ~ 27

Author(s):

Szu-Yuan Chen ◽

Chun-Ying Cheng ◽

Shih-Sheng Chang ◽

Min-Chain Tsai ◽

Chih-Hao Chiu ◽

...

Keyword(s):

Posterior Cruciate Ligament ◽

Cruciate Ligament ◽

Suture Fixation ◽

Avulsion Fractures

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Arthroscopic Suture Fixation of Comminuted Tibial Eminence Fractures: Hybrid All-Epiphyseal Bone Tunnel and Knotless Anchor Technique

Arthroscopy Techniques ◽

10.1016/j.eats.2019.06.018 ◽

2019 ◽

Vol 8 (11) ◽

pp. e1283-e1288 ◽

Cited By ~ 1

Author(s):

Joseph C. Fox ◽

Michael G. Saper

Keyword(s):

Bone Tunnel ◽

Suture Fixation ◽

Knotless Anchor ◽

Tibial Eminence ◽

Epiphyseal Bone

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Arthroscopic Two-Point Suture Bridge Fixation Technique for the Treatment of Anterior Cruciate Ligament Tibial Avulsion Fractures

Journal of Biomaterials and Tissue Engineering ◽

10.1166/jbt.2021.2776 ◽

2021 ◽

Vol 11 (10) ◽

pp. 1977-1982

Author(s):

Dong Zheng ◽

Jianjian Yin ◽

Long Han ◽

Jianchao Gui

Keyword(s):

Anterior Cruciate Ligament ◽

Avulsion Fracture ◽

Cruciate Ligament ◽

Suture Fixation ◽

Fixation Technique ◽

Avulsion Fractures ◽

Anterior Drawer ◽

Kt 1000 ◽

Anterior Cruciate

This study aimed to present and evaluate a new arthroscopic technique that uses two-point suture fixation for anterior cruciate ligament (ACL) tibial avulsion fractures. A total of 15 patients diagnosed with ACL tibial avulsion fracture underwent arthroscopic suture fixation from November 2018 to October 2019 and were treated using two-point suture fixation. The patients were followed up and evaluated according to Lysholm scores, International Knee Documentation Committee (IKDC) subjective scores, Tegner activity level scales, anterior drawer testing, and KT-1000 arthrometer testing. The mean follow-up period was 18 months (12 to 24). All patients had a negative Lachman test and anterior drawer test at final follow-up and showed the radiological union of avulsion fracture at 12-week postoperative radiograph. The Lysholm score improved significantly postoperatively with a mean score of 94.26±3.63 (87 to 98; p < 0.001). The Tegner score improved significantly postoperatively from 3.61 ±1.37 to 7.14±1.51 (P < 0.001). The KT-1000 measured value decreased significantly postoperatively from 7.3±1.5 to 1.4 ±1.2 (P < 0.001). The IKDC category was abnormal or severely abnormal preoperatively, and all patients improved to normal or nearly normal at final follow-up. Arthroscopic treatment using the two-point suture fixation technique is effective for ACL avulsion fracture and can restore the function and stability of the knee joint.

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