Evaluation of Knee Joint after Open Reduction and Internal Fixation Surgery of Posterior Cruciate Ligament in Patients with Avulsion Fracture

Salehi, Navid; Azarifar, Faeze; Jahanshahi, Arman; Mohammadi, Hamidreza

doi:10.3889/oamjms.2019.185

Cited by 3 publications

(3 citation statements)

References 11 publications

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“…[ 1 , 16 , 17 ] Conservative treatment may result in fracture nonunion, posterior instability of the joint, and irreversible osteoarthritis in the long term. [ 13 , 16 , 18 ] Therefore, if there is a displacement of more than 5 mm at the PCL attachment, surgery is considered necessary. [ 8 ]…”

Section: Discussionmentioning

confidence: 99%

The degree of fracture reduction does not compromise the clinical efficacy of arthroscopic reduction and fixation of tibial posterior cruciate ligament avulsion fractures: A retrospective study

Zhou,

Wang,

Xiao

et al. 2023

Medicine

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This study aimed to explore the postoperative outcomes of patients who underwent arthroscopic internal fixation with repositioning sutures for the treatment of posterior cruciate ligament (PCL) avulsion fractures with poorly reduced fracture fragments. It was hypothesized that improperly repositioned fracture fragments might not influence the postoperative clinical outcomes in patients with PCL avulsion fractures treated by arthroscopic sutures. From January 2020 to December 2021, patients admitted to our hospital with PCL avulsion fractures were evaluated. Our inclusion criteria were as follows: diagnosis of PCL avulsion fracture as Meyers & McKeever Type II or Type III; underwent arthroscopic double tunnel suture fixation; and age below 70. Of the patients meeting these criteria, data from 34 individuals were collected by a designated follow-up officer. Based on postoperative imaging, the patients were divided into 2 groups: well fracture reduction and poor fracture reduction groups. Prior to the surgery, the Lysholm score, knee mobility, and international knee documentation committee (IKDC score) were recorded for both groups. At the 3-month post-surgery mark, CT-3D reconstruction was performed. Statistical analysis was conducted on the collected data. For data that conformed to a normal distribution, the t test was applied. For data that didn’t conform, we used a non-parametric test. Both groups achieved successful wound healing without encountering any adverse events, such as fracture nonunion infection. Fracture healing was observed in both groups at the 3-month postoperative mark. The average follow-up duration was 13.24 ± 6.18 months. There were no significant differences in Lysholm score, IKDC score, or knee mobility between the well- and poorly-reduced groups at the final follow-up (P > .05). Postoperatively, both groups demonstrated significant improvements in knee function compared to the preoperative scores, with statistically significant differences observed in Lysholm score, IKDC score, and knee mobility (P < .05). Arthroscopic fixation with double-tunnel sutures proved to be a highly effective treatment approach for PCL avulsion fractures, even in cases where the fractures were poorly reduced. Remarkably, there were no significant differences observed in postoperative knee function between the well- and poorly-reduced groups, indicating that both groups achieved favorable outcomes.

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Section: Discussionmentioning

confidence: 99%

The degree of fracture reduction does not compromise the clinical efficacy of arthroscopic reduction and fixation of tibial posterior cruciate ligament avulsion fractures: A retrospective study

Zhou,

Wang,

Xiao

et al. 2023

Medicine

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“…PCL is a strong ligament. Therefore avulsion injury to the tibial attachment frequently occurred [1]. It may lead to chronic knee pain, instability, further injury to other knee structures and induced early joint arthrosis if left untreated [1], [2].…”

Section: Introductionmentioning

confidence: 99%

“…Therefore avulsion injury to the tibial attachment frequently occurred [1]. It may lead to chronic knee pain, instability, further injury to other knee structures and induced early joint arthrosis if left untreated [1], [2]. The treatment itself varied from conservative treatment, surgical open reductioninternal fixation to arthroscopically assisted fixation [2], [3], [4].…”

Section: Introductionmentioning

confidence: 99%

An Unusual Case of Anteriorly Displaced Posterior Cruciate Ligament Tibial Attachment Avulsion Injury

Utomo

Santoso

Anwar

et al. 2019

Open Access Maced J Med Sci

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BACKGROUND: Avulsion injury to the tibial attachment of posterior cruciate ligament (PCL) is frequently occur. The purpose of this report is to highlight an unusual variation of PCL avulsion injury. CASE PRESENTATION: A 24-year-old female was suffered a motorcycle accident 1 day before admission. The patient complained of severe right knee pain. Plain radiograph and CT-scan revealed an anteriorly displaced tibial attachment PCL avulsion fracture. Open surgical fixation was done to the patient. A satisfactory outcome was observed until the final 1-year follow-up. CONCLUSIONS: The bony fragment of the tibial attachment of posterior cruciate ligament avulsion injury can be displaced to the anterior compartment of the knee. Concomitant injury to other knee structures should be suspected when finding this case. Special consideration is also needed during the management of this unusual case.

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Systematic Review and Meta-analysis of Clinical Outcomes After Management of Posterior Cruciate Ligament Tibial Avulsion Fractures

Gopinatth,

Mameri,

Casanova

et al. 2023

Orthopaedic Journal of Sports Medicine

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Background: There is no consensus regarding the management of posterior cruciate ligament (PCL) avulsion fractures and the expected outcomes after treatment. Purpose: To systematically review clinical outcomes and complications after management of tibial-sided avulsion fractures of the PCL. Study Design: Systematic review; Level of evidence, 4. Methods: A literature search of Scopus, PubMed, Medline, and the Cochrane Central Register for Controlled Trials was performed in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included were studies with evidence levels 1 to 4 that reported clinical outcomes after treatment of PCL tibial-sided avulsion fractures in humans. The quality of the included studies was performed using the Methodological Index for Non-Randomized Studies (MINORS) criteria. A meta-analysis was performed for patient-reported outcome measures using random-effects modeling with 95% CIs. Results: A total of 58 studies published between 1999 and 2022 were identified. The mean MINORS score was 9.90 ± 4.12, indicating overall low-quality evidence with high risk of bias. The studies comprised 1440 patients (mean age, 32.59 ± 5.69 years; 75.2% males) with a mean follow-up of 26.9 ± 19.6 months (range, 5.3-126 months). Most patients were treated with open surgery (63.6%), followed by arthroscopic surgery (29.7%) and nonoperative treatment (6.7%). All patients reported significant posttreatment improvement in both subjective and objective outcomes ( P < .05 for all). Arthroscopic surgery was associated with lower postoperative posterior tibial translation compared with open surgery (range, 0.6-3.2 vs 1.7-3.1 mm), greater preoperative to postoperative improvement in Lysholm score (54.6 vs 48.8; P < .0001), higher postoperative Tegner score (6.64 ± 1.03 vs 6.14 ± 2.29; P = .0448), and a higher rate of return to sport (100% vs 89.5%; P = .009). Nonoperative management was associated with a significantly lower fracture union rate (87% vs 99.1%; P < .0001) and greater postoperative side-to-side posterior translation (4.9 ± 4.3 mm) when compared with operative management. Conclusion: Although nonoperative and surgical management of PCL tibial avulsion fractures resulted in high rates of fracture union and improvement in functional outcome scores and a low incidence of complications, nonoperative treatment yielded a high side-to-side posterior displacement (>4 mm) with a lower rate of fracture union compared to surgical treatment.

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Evaluation of Knee Joint after Open Reduction and Internal Fixation Surgery of Posterior Cruciate Ligament in Patients with Avulsion Fracture

Cited by 3 publications

References 11 publications

The degree of fracture reduction does not compromise the clinical efficacy of arthroscopic reduction and fixation of tibial posterior cruciate ligament avulsion fractures: A retrospective study

The degree of fracture reduction does not compromise the clinical efficacy of arthroscopic reduction and fixation of tibial posterior cruciate ligament avulsion fractures: A retrospective study

An Unusual Case of Anteriorly Displaced Posterior Cruciate Ligament Tibial Attachment Avulsion Injury

Systematic Review and Meta-analysis of Clinical Outcomes After Management of Posterior Cruciate Ligament Tibial Avulsion Fractures

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