scholarly journals Open Posterior Approach versus Arthroscopic Suture Fixation for Displaced Posterior Cruciate Ligament Avulsion Fractures: Systematic Review

2018 ◽  
Vol 30 (4) ◽  
pp. 275-283 ◽  
Author(s):  
Jae-Gwang Song ◽  
Kyung-Wook Nha ◽  
Se-Won Lee
Keyword(s):  
Systematic Review ◽  
Posterior Cruciate Ligament ◽  
Posterior Approach ◽  
Cruciate Ligament ◽  
Suture Fixation ◽  
Avulsion Fractures

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

2012 ◽  
Vol 28 (10) ◽  
pp. 1454-1463 ◽  
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

Management of Posterior Cruciate Ligament Tibial Avulsion Injuries: A Systematic Review

2017 ◽  
Vol 46 (3) ◽  
pp. 734-742 ◽  
Author(s):  
Perry O. Hooper ◽  
Chris Silko ◽  
Tennison L. Malcolm ◽  
Lutul D. Farrow
Keyword(s):  
Systematic Review ◽  
Surgical Treatment ◽  
Posterior Cruciate Ligament ◽  
English Language ◽  
Cruciate Ligament ◽  
Open Group ◽  
Treatment Modalities ◽  
Avulsion Fractures ◽  
Bony Avulsion ◽  
Patient Reported

Background: Tibial-sided avulsion injuries of the posterior cruciate ligament (PCL) generally require surgical intervention. No consensus exists concerning the optimal surgical treatment approach for these injuries. Purpose: To perform a systematic review investigating the open and arthroscopic surgical treatment modalities, outcomes, and complications of PCL tibial-sided bony avulsions. Study Design: Systematic review; Level of evidence, 4. Methods: The authors performed a systematic review of the literature utilizing PubMed and EMBASE from 1975 to present outlining open versus arthroscopic surgical repair of PCL bony avulsion injuries and comparing subjective and objective postoperative patient-reported outcomes, including Tegner, IKDC (International Knee Documentation Committee), and Lysholm scoring systems, as well as rates of patient complications. The quest was performed in June 2016, and searched terms included posterior cruciate ligament, PCL, bony, avulsion(s), tibial-sided, open, and arthroscopic. Inclusion criteria included English-language studies involving surgical fixation strategies for PCL tibial-sided bony avulsions. Exclusion criteria included non-English language, case studies/case series, and subject matter not pertaining to PCL bony avulsions. Results: Twenty-eight articles comprising 637 patients met the criteria and were included in the final review. PCL injuries with a tibial-sided avulsion were the result of motor vehicle accidents in 68.4% of patients, with 59.0% of these injuries resulting from motorcycle accidents. The arthroscopic group had better IKDC grade A scores (78.9%), indicating a normal knee postoperatively, as compared with the open group (65.9%). The postoperative Lysholm scores were similar between the groups, with a mean of 95.0 in the arthroscopic group and 92.8 in the open group. The arthroscopic group also reported 100% return to preinjury level of activity, compared with 86.2% in the open group. The most common complication in both groups was arthrofibrosis, which was reported more often in the arthroscopic group (0%-35%) versus the open treatment group (0%-25%). Conclusion: In patients with displaced tibial-sided PCL avulsion fractures treated operatively, surgical approaches render similar outcomes and risks. While the arthroscopic group had somewhat higher subjective and objective knee outcome scores, it demonstrated a slightly higher rate of arthrofibrosis. The clear advantage of the arthroscopic approach is that concomitant intra-articular injuries seen on preoperative magnetic resonance imaging, such as meniscal tears or osteochondral loose fragments, can be addressed at the time of the index operation.

scholarly journals A New Modified Open Posterior Approach for the Fixation of Posterior Cruciate Ligament Tibial Avulsion Fractures

2016 ◽  
Vol Inpress (Inpress) ◽  
Author(s):  
Babak Mirzashahi ◽  
Arvin Najafi ◽  
Pejman Mansouri ◽  
Mahmoud Farzan
Keyword(s):  
Posterior Cruciate Ligament ◽  
Posterior Approach ◽  
Cruciate Ligament ◽  
Avulsion Fractures

scholarly journals Arthroscopic Suture Fixation With Autograft Augmentation Reconstruction for Delayed Tibial Avulsion Fractures of the Posterior Cruciate Ligament

2020 ◽  
Vol 8 (8) ◽  
pp. 232596712094404
Author(s):  
Mingguang Bi ◽  
Chen Zhao ◽  
Jihang Chen ◽  
Zheping Hong ◽  
Zhen Wang ◽  
...  
Keyword(s):  
Posterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Case Series ◽  
Suture Fixation ◽  
Level Of Evidence ◽  
Avulsion Fractures ◽  
Posterior Drawer ◽  
Kt 1000 ◽  
The Mean

Background: The optimal surgical treatment of delayed avulsion fractures of the posterior cruciate ligament (PCL) is still controversial. Purpose: To evaluate the clinical results of arthroscopic suture fixation of tibial avulsion fractures of the PCL with autograft augmentation reconstruction. Study Design: Case series; Level of evidence, 4. Methods: From January 2013 to February 2017, we treated 15 patients with delayed tibial avulsion fractures of the PCL arthroscopically through posteromedial and posterolateral portals. The PCL and avulsion bone fragment were fixed with No. 2 nonabsorbable FiberWire sutures that were pulled out through a single tibial bone tunnel and fixed on a small Endobutton. Concomitantly, anatomic PCL augmentation reconstruction was performed, and the graft was pulled out through the same tunnel and fixed with an interference screw. Knee stability was assessed using the posterior drawer test, and the side-to-side difference was determined using a KT-1000 arthrometer with 134 N of posterior force at 30° of knee flexion. The International Knee Documentation Committee (IKDC) 2000 subjective form and Lysholm scale were used to evaluate clinical outcomes at follow-up. Overall, 12 patients were enrolled for analysis. The mean follow-up period was 34.4 months (range, 26-49 months). Results: At the final follow-up, 2 patients encountered 10° terminal flexion limitations. All patients had negative posterior drawer test results. The KT-1000 arthrometer side-to-side difference was significantly decreased from 8.25 ± 1.96 mm preoperatively to 1.08 ± 0.86 mm at the last follow-up ( P < .001). The mean IKDC and Lysholm scores, respectively, increased from 54.67 ± 7.13 and 53.50 ± 7.90 preoperatively to 91.13 ± 3.78 and 94.25 ± 3.32 at the final follow-up ( P < .001 for both). Conclusion: Arthroscopic suture fixation with autograft augmentation reconstruction for delayed tibial avulsion fractures of the PCL showed good clinical stability and function in this study.

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