Arthroscopic suture bridge fixation technique with multiple crossover ties for posterior cruciate ligament tibial avulsion fracture

Yoon, Joonsung; Park, Chan-Deok; Lee, Dae-Hee

doi:10.1007/s00167-016-4339-z

Cited by 32 publications

(29 citation statements)

References 21 publications

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“…Previous studies mainly focused on the surgical technique or clinical outcomes of this injury [3][4][5]. To our knowledge, our study is the rst to identify the association between MRI measurements of the knee and PCL avulsion fracture and nd the independent factor that may help explain the risk of PCL avulsion fracture and the predisposition of patients toward knee injury.…”

Section: Discussionmentioning

confidence: 87%

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What is the impact of knee morphology on posterior cruciate ligament avulsion fracture in men and women: a case control study

Fan

Zheng

Zang

et al. 2020

Preprint

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Background Several studies on the relationship between morphological parameters and traumatic diseases of the knee have already been conducted. However, few studies focused on the association between knee morphology and posterior cruciate ligament (PCL) avulsion fracture in adults. The objective of this study was to evaluate the impact of knee morphology on PCL avulsion fracture and determine risk factors in men and women separately. Methods A retrospective case-control study of 48 patients (comprised 25 men and 23 women) with PCL avulsion fracture compared with 48 age- and sex-matched controls was performed from 2012 to 2018. MRI measurements of the knee were acquired in the sagittal, coronal, and axial sequences. The assessed measurements including intercondylar notch width index, medial/lateral posterior tibial slopes, and coronal tibial slope were compared between case and control groups in both women and men. Univariable and binary logistic regression analyses were used to identify independent risk factors that were associated with PCL avulsion fracture. Results When female patients were analyzed, the notch width index (coronal) was significantly smaller, and the lateral posterior tibial slope was significantly higher in the case group. The binary logistic regression analysis showed that the notch width index (coronal) (B = -0.307, OR = 0.735, p = 0.025) was found to be an independent factor. When male patients were analyzed, no radiographic parameter was found to have a statistical difference between the case and control groups. Conclusions Notch width index (coronal) and lateral posterior tibial slope were found to affect PCL avulsion fracture in women, but no such measurements affected the PCL avulsion fracture in men. Furthermore, a smaller notch width index (coronal) in women was found to be a risk factor in PCL avulsion fracture.

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Section: Discussionmentioning

confidence: 87%

“…It is generally agreed that a displaced PCL avulsion fracture should be anatomically reduced and xed. Both open and arthroscopic methods of xation have been reported to produce good outcomes [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

What is the impact of knee morphology on posterior cruciate ligament avulsion fracture in men and women: a case control study

Fan

Zheng

Zang

et al. 2020

Preprint

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“…Other arthroscopic techniques have also been described using the suture bridge method, 18,19 percutaneous screws, 20,21 suture anchors 22 or suture fixations. 1,[14][15][16] The suture bridge technique has been studied to have good clinical outcomes but has a possible steeper learning curve than the TightRope technique described in this article.…”

Section: Discussionmentioning

confidence: 99%

“…7 Minimally invasive and arthroscopic approaches have since been developed to mitigate the risks associated with open surgical approaches. 1,[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] Arthroscopic surgical fixation of isolated PCL avulsion fractures has been described 8,9 with limited clinical data. The technique of suspensory fixation devices has also been described to simplify the procedure.…”

Section: Introductionmentioning

confidence: 99%

Short-term clinical outcomes of arthroscopic fixation of displaced posterior cruciate ligament avulsion fractures with the use of an adjustable loop suspensory device

Han

Pearce

Lee

2019

J Orthop Surg (Hong Kong)

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Introduction: To describe the clinical outcomes of arthroscopic fixation of displaced posterior cruciate ligament (PCL) avulsion fractures with/without associated tibia plateau fractures using an adjustable loop suspensory fixation device. Methods: Four male patients who have sustained PCL tibia avulsion fractures with/without associated tibia plateau fractures were operated on in a single centre using an arthroscopic adjustable loop suspensory device technique. After arthroscopic evaluation and reduction of the fracture using a probe and PCL drill guide, a proximal medial tibial mini incision was used to drill a bone tunnel through the fracture fragment. An adjustable loop suspensory device was relayed through the bone tunnel via a transtibial manner, and the button device was flipped onto the bony fragment for fixation. The associated tibial plateau fractures were then fixed if present. Knee function at the last follow-up was evaluated by International Knee Documentation Committee (IKDC), Knee Injury And Osteoarthritis Outcome Score (KOOS), Lysholm scores. Range of motion and knee stability were assessed, and fracture union was evaluated by plain radiographs. Results: All patients underwent the operation successfully with no major complications encountered. All were followed up for a minimum of 6 months. There was no instability reported by the patients or found during objective evaluation using posterior drawer test and reverse pivot shift test. All fractures achieved union. Mean post-operative Lysholm score was 91.5 (range 85-95), IKDC score was 85.1 (range 74.7-89.7) and KOOS was 89.3 (range 81.5-94.6). All patients returned to their pre-injury activities of daily living and work. Radiographic evaluation showed union at the fracture site in all four patients at the last follow-up. Conclusion: This arthroscopic procedure is a viable minimally invasive technique that is appropriate in minimally displaced avulsion fractures of the PCL with associated tibia plateau fractures.

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“…3 The restoration of normal anatomy and biomechanics of the PCL is crucial for the return of the function and stability of the knee while avoiding the late arthritis of the knee. 4 The fixation techniques for PCL avulsion fracture varies from arthroscopic techniques 5 to open reduction and internal fixation (ORIF) with cannulated cancellous screws, Kirschner wires, and sutures anchors. [6][7][8] Although the management of single, large, noncomminuted bony avulsion injury have shown universally good results after open or arthroscopic repair, the treatment of comminuted PCL avulsion injury remains controversial regarding the most optimal method.…”

Section: Introductionmentioning

confidence: 99%

Management of comminuted tibial end bony avulsion of posterior cruciate ligament by open posterior approach using suture bridge technique: A case series

Pandey

Mathai

Varshini

et al. 2017

Journal of Clinical Orthopaedics and Trauma

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Arthroscopic suture bridge fixation technique with multiple crossover ties for posterior cruciate ligament tibial avulsion fracture

Abstract: IV.

Cited by 32 publications

References 21 publications

What is the impact of knee morphology on posterior cruciate ligament avulsion fracture in men and women: a case control study

What is the impact of knee morphology on posterior cruciate ligament avulsion fracture in men and women: a case control study

Short-term clinical outcomes of arthroscopic fixation of displaced posterior cruciate ligament avulsion fractures with the use of an adjustable loop suspensory device

Management of comminuted tibial end bony avulsion of posterior cruciate ligament by open posterior approach using suture bridge technique: A case series

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