Treatment of tibia avulsion fracture of posterior cruciate ligament with total arthroscopic internal fixation with adjustable double loop plate: a retrospective cohort study

Background We aimed to evaluate the effect of a surgery technique-total arthroscopic internal fixation with adjustable double loop plate in treatment of patients with tibia avulsion fracture of posterior cruciate ligament (PCL). Methods From April 2018 to January 2020, 26 patients with tibia avulsion fracture of PCL treated in the joint surgery of our hospital were enrolled in this retrospective cohort study. According to the way of operation, the patients were divided into the experimental group (receiving total arthroscopic internal fixation with an adjustable double loop plate) and the control group (receiving traditional open surgery). The knee joint X-ray, CT or magnetic resonance imaging (MRI) were used to evaluate the injury or the fixation effect. Results There were no significant differences in baseline patient demographics between the two groups in terms of age, sex, the average time from injury to surgery, type of surgery, preoperative knee range of motion, Lysholm score, IKDC score and KT-1000 score (P>0.05). The average operation time in the experimental group (59.5 ± 10.6 minutes) was significantly shorter than that in the control group (96.8 ± 13.7 minutes) (P < 0.05). Postoperative re-examination of knee CT and X-ray showed that the fracture fragments were well fixed in all patients. The fracture was all healed 2 months after the operation. Post-operative posterior drawer tests were negative in all patients at final follow-up. All patients regained a satisfactory knee range of motion and the flexion and extension function and were satisfied with the results of surgery and rehabilitation. There was significant difference (P < 0.05) in the Lysholm scores, the IKDC scores, the KT1000 scores, and the ROM between preoperative and postoperative values in the control group and the experimental group. However, there were no significant differences in these values between the two groups (p>0.05).Conclusions Total arthroscopic internal fixation with adjustable double loop plate is relatively simple, safe, minimally invasive, and reliable. After taking this operation and rehabilitation training, patients with tibia avulsion fracture of PCL can regain a satisfactory knee range of motion and the flexion and extension function.

Large chondral fragment of the lateral femoral condyle treated with arthroscopic internal fixation in an elite young athlete

Focal chondral lesions in the adolescent population create a particular challenge for orthopedic surgeons, and currently there exists no consensus on proper treatment. Numerous techniques for addressing focal chondral defects are employed in both pediatrics and adults, including fragment excision, debridement and fixation, bone marrow stimulation and microfracture techniques, cell-based options, as well as chondral and osteochondral grafts. Although historical evidence is mixed, recent reports of primary fixation of displaced cartilage fragments have shown favorable results. We present a case of reduction and fixation of a large displaced cartilage lesion in an elite young tennis player. Our results, in addition to other reports mentioned in this manuscript, highlight the importance of considering primary fixation of large chondral lesions when amenable to repair.