Anterior Cruciate Ligament Function after Tibial Eminence Fracture in Skeletally Mature Patients

2001 ◽  
Vol 29 (3) ◽  
pp. 339-345 ◽  
Author(s):  
Christopher S. Ahmad ◽  
Beth E. Shubin Stein ◽  
Winston Jeshuran ◽  
Ohannes A. Nercessian ◽  
Jack H. Henry
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Tibial Eminence Fracture ◽  
Tibial Eminence ◽  
Anterior Cruciate

scholarly journals Enlarged tibial eminence may be a protective factor of anterior cruciate ligament

2020 ◽  
Vol 144 ◽  
pp. 110230
Author(s):  
Yujia Li ◽  
Ke Chou ◽  
Wei Zhu ◽  
Jiepeng Xiong ◽  
Min Yu
Keyword(s):  
Anterior Cruciate Ligament ◽  
Protective Factor ◽  
Cruciate Ligament ◽  
Tibial Eminence ◽  
Anterior Cruciate

scholarly journals DO TIBIAL EMINENCE FRACTURES AND ANTERIOR CRUCIATE LIGAMENT TEARS HAVE SIMILAR OUTCOMES?

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0011
Author(s):  
Heath P. Melugin ◽  
Vishal S. Desai ◽  
Christopher Camp ◽  
Timothy E. Hewett ◽  
Todd A. Milbrandt ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Activity Levels ◽  
Injury Rates ◽  
Tibial Eminence ◽  
Anterior Laxity ◽  
Surgical Fixation ◽  
Anterior Cruciate

Background: Avulsion fractures involving the tibial eminence are considered equivalent in etiology to anterior cruciate ligament tears, however there is limited data comparing outcomes of adolescent patients undergoing surgical fixation of tibial eminence fractures to those undergoing anterior cruciate ligament (ACL) reconstruction. Purpose: The purpose of this study was to compare clinical outcomes, subsequent ACL injury rates, and activity levels between adolescent patients who underwent tibial eminence fracture fixation to patients with mid-substance ACL tears who required acute ligament reconstruction. Methods: This study included a group of patients with tibial eminence fractures treated with surgical fixation matched to a group of similar patients with ACL tears treated with reconstruction between the years of 2001 and 2015. Data regarding initial injury, surgical intervention, ACL/ACL graft injury rates, and physical examination findings were recorded. Clinical and functional outcomes were obtained using physical examination, IKDC subjective scores, Lysholm scores, and Tegner Activity levels. Results: Sixty patients with a mean follow-up of 57.7 (24-206) months were included. 20 patients (11 M:9 F) who underwent surgical fixation for tibial eminence fractures (TEF) with a mean age of 11.9 (7-15) years were matched to a group of 40 patients (23 M:17 F) who underwent ACL reconstruction for ACL tears with a mean age of 12.5 (8-15) years. The TEF group demonstrated significantly lower postoperative IKDC (TEF group: 94.0, ACL group: 97.2 (p=0.04)) and Lysholm scores (TEF group: 92.4, ACL group: 96.9 (p=0.02)). The TEF group returned to sport 121 days sooner (p<0.01), but there was no difference in postoperative Tegner scores (TEF group: 7.3, ACL group: 7.6 (p=0.16)). The TEF group demonstrated increased postoperative anterior laxity (p=0.02) and a higher rate of postoperative arthrofibrosis (p=0.04). There was no difference in subsequent ACL injury (p=0.41). Conclusion: Patients with tibial eminence fractures demonstrated lower mean clinical outcome scores compared to patients with ACL tears at minimum 2-year follow up. Additionally, they experienced more postoperative anterior laxity and had a higher rate of postoperative arthrofibrosis. There was no difference in subsequent ACL injury rate. The TEF group returned to sport sooner than the ACL group, but the postoperative activity level was similar.

scholarly journals Combining pullout suture and retrograde screw fixation for anterior cruciate ligament tibial eminence avulsion fractures: A case report

2020 ◽  
Vol 28 (2) ◽  
pp. 230949902091868
Author(s):  
Takaaki Hiranaka ◽  
Takayuki Furumatsu ◽  
Takaaki Tanaka ◽  
Yuki Okazaki ◽  
Yuya Kodama ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Screw Fixation ◽  
Cruciate Ligament ◽  
Weight Bearing ◽  
International Knee Documentation Committee ◽  
Avulsion Fractures ◽  
Tibial Eminence ◽  
Arthroscopic Fixation ◽  
Anterior Cruciate ◽  
Bone Tunnels

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.

Anterior Cruciate Ligament Insertions on the Tibia and Femur and Their Relationships to Critical Bony Landmarks Using High-Resolution Volume-Rendering Computed Tomography

2008 ◽  
Vol 36 (11) ◽  
pp. 2083-2090 ◽  
Author(s):  
Mark L Purnell ◽  
Andrew I. Larson ◽  
William Clancy
Keyword(s):  
Computed Tomography ◽  
Anterior Cruciate Ligament ◽  
Volume Rendering ◽  
Cruciate Ligament ◽  
Lateral Meniscus ◽  
Anterior Border ◽  
Tibial Eminence ◽  
Bony Landmarks ◽  
Tibial Condyle ◽  
Anterior Cruciate

Background Controversy exists regarding the locations of the anterior cruciate ligament insertions on the femur and tibia and visualization of these insertions during surgical reconstruction. Hypothesis Anatomical insertions of the anterior cruciate ligament have relationships to bony landmarks of the tibia and femur. Study Design Descriptive laboratory study. Methods Eight cadaveric knees were scanned by computed tomography, reconstructed 3-dimensionally, and examined from simulated arthroscopic, sagittal, and axial perspectives. Volume-rendering software was used to document the relationship of the anterior cruciate ligament to the bony anatomy. Results A bony ridge (Resident's Ridge) at the anterior border of the anterior cruciate ligament was readily noted on the medial wall of the lateral femoral condyle. Superiorly, anterior cruciate ligament fibers inserted up to the roof of the notch and to 3 to 3.5 mm of the articular surface posteriorly and interiorly. The anterior cruciate ligament inserted into a fovea anterior to the tibial eminence. Posteriorly, anterior cruciate ligament fibers inserted up to a ridge between the medial and lateral intercondylar tubercles. Medially, anterior cruciate ligament fibers inserted onto the ridge at the lateral border of the medial tibial condyle. There was no distinct anterior or lateral bony border with anterior cruciate ligament fibers blending into the anterior horn of the lateral meniscus. Conclusion The anterior border of the femoral anterior cruciate ligament origin is Resident's Ridge. The ridge between the medial and lateral intercondylar tubercles at the base of the tibial eminence is the posterior margin of the anterior cruciate ligament on the tibia. Clinical Relevance Bony landmarks can be used to aid in anatomical anterior cruciate ligament reconstruction.

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