Single-Stage Arthroscopy-Assisted Reduction and Internal Fixation (ARIF) of Tibial Rim Fracture With Posterior Cruciate Ligament Reconstruction and Repair of Posterolateral Complex and Meniscal Injury

Sundararajan, Silvampatti Ramasamy; D’souza, Terence; Ramakanth, Rajagopalakrishnan; Rajasekaran, Shanmuganathan

doi:10.1016/j.eats.2021.07.027

Cited by 3 publications

(3 citation statements)

References 17 publications

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“…However, this injury mechanism does not account for every case. In some literatures and in our cases, there have been large tibial plateau fractures, that are more than 25% of anteroposterior length of the medial tibial plateau, co-occurred with PCL and PLC injuries [ 7 , 17 ]. This atypical presentation may be related to the intensity of the trauma.…”

Section: Discussionmentioning

confidence: 98%

“…However, arthroscopic techniques were not used in these cases. In 2021, Sundararajan et al [ 17 ] reported single-stage surgery for these injuries with ARIF of a tibial rim fracture with PLC repair and PCL reconstruction, but the efficacy of the patient's postoperative recovery was not described.…”

Section: Discussionmentioning

confidence: 99%

“…However, the management of the bony concomitant injuries in ligamentous damage is still unclear, especially anteromedial tibial plateau fracture with PLC injury. For the treatment options, almost all clinicians choose to complete the repair or reconstruction of all injured structures in a single-stage treatment [ 15 – 17 ]. There has also been a study that proposed the reduction and internal fixation of tibial plateau fracture and PLC repair in one-stage surgery, and PCL reconstruction was completed in two-stage surgery [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

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Single-stage arthroscopic-assisted treatment of anteromedial tibial plateau fracture with posterolateral corner injury: a retrospective study

et al. 2022

BMC Musculoskelet Disord

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Background Anteromedial tibial plateau fracture with posterolateral corner (PLC) injury is a relatively rare combined injury in the clinic. In addition, there is no unified treatment scheme for this combined injury. The purpose of this study was to evaluate the clinical and imaging results of single-stage arthroscopic-assisted surgery for anteromedial tibial plateau fracture with PLC injury, and to explore the advantages of this surgical technique. Method In this retrospective study, a total of 9 patients (7 males and 2 females) were included, aged 24–64 years (average 40.7 years), treated in our Department of Orthopedics from January 2016 to January 2021. In the preoperative evaluations, there were 9 cases of anteromedial tibial plateau fractures with PLC injuries, 6 cases of concomitant PCL injuries, 6 cases of concomitant medial or lateral meniscus injuries, and 2 cases of concomitant fibular head avulsion fractures. All patients underwent single-stage arthroscopic-assisted surgery. Results All patients were followed up, and the average follow-up period was 15.2 months (range 12–18 months). The average operation time was 135.6 min (range 100–160 min), and the average surgical blood loss was 87.2 ml (range 60–110 ml). The anatomical reduction was achieved in 9 cases, and the anatomical reduction rate was 100%. The average fracture healing time was 13.1 weeks (range 12–16 weeks). At the last follow-up, the average VAS score was 1 (range 0–2); the average Lysholm function score was 90.7 (range 86–95), and the average IKDC score was 91.4 (range 88–95); the average knee extension angle of all patients was 0° and the average knee flexion angle was 128.3° (average 120–135°); The posterior drawer test, the Lachman test and the dial test were negative for all cases. None of the patients had operation-related complications. Conclusion Single-stage arthroscopy-assisted surgery in the treatment of anteromedial tibial plateau fracture with PLC injury can achieve good clinical outcomes, restore the stability of the knee joint, and reduce the risk of severe lower extremity dysfunction.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Single-stage arthroscopic-assisted treatment of anteromedial tibial plateau fracture with posterolateral corner injury: a retrospective study

et al. 2022

BMC Musculoskelet Disord

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Augmented suture pull-out with suture-button(triple fixation) yields less radiological residual laxity than suture pull-out technique–for Arthroscopic reduction and internal fixation of posterior cruciate ligament avulsion fractures.

Ramakanth,

Silvampatti Ramasamy,

Muhammed

et al. 2024

Journal of ISAKOS

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Clinical outcomes of arthroscopic suture fixation combined with loop plate vs. posterior approach open reduction and cannulated screw fixation for treating tibial avulsion fractures of the posterior cruciate ligament: a retrospective study

Zhang,

Guo

2024

PeerJ

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Background Comparison of the efficacy of arthroscopic suture fixation combined with loop plate vs. the posterior approach involving open reduction and intramedullary nail fixation in treating posterior cruciate ligament tibial avulsion fractures (PCLTAFs). Methods A retrospective analysis was conducted on the clinical data of patients diagnosed with PCLTAF who were admitted to Northern Jiangsu People’s Hospital between June 2019 and March 2022. Based on distinct surgical procedures, the patients were categorized into two groups: arthroscopic group (33 cases), involving a single bone tunnel, high-strength suture, loop plate, and anchor screw fixed under arthroscopy, and open reduction and internal fixation (ORIF) group (13 cases), involving a modified posterior medial approach and fixation using 1–2 cannulated screws. Key parameters, including surgical duration, postoperative fracture alignment, fracture-healing duration, range of motion changes, postoperative Lysholm scores, and VAS scores were documented and compared between the two groups. Results The study cohort comprised 46 patients, with 28 males and 18 females, and the median age was 29 years old (range: 15–69). There were no significant differences in the baseline characteristics, including knee Lysholm scores, between the two groups. The arthroscopic group exhibited significant improvement in all eight Lysholm score indicators (all P < 0.001). The total Lysholm score also exhibited significant improvement before and after surgery in both groups (P < 0.001). Following surgery, the arthroscopic group demonstrated improvements in all indicators, but had a slightly longer operating time compared to the ORIF group. No significant differences were observed in the Lysholm scores for the knee joint between the two patient groups before and after surgery (P > 0.05). Conclusions Arthroscopic suture fixation in conjunction with looped plate binding can significantly improve knee function and clinical effect for patients in the treatment of PCLTAF, promotingearly postoperative functional recovery of patients.

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Single-Stage Arthroscopy-Assisted Reduction and Internal Fixation (ARIF) of Tibial Rim Fracture With Posterior Cruciate Ligament Reconstruction and Repair of Posterolateral Complex and Meniscal Injury

Cited by 3 publications

References 17 publications

Single-stage arthroscopic-assisted treatment of anteromedial tibial plateau fracture with posterolateral corner injury: a retrospective study

Single-stage arthroscopic-assisted treatment of anteromedial tibial plateau fracture with posterolateral corner injury: a retrospective study

Augmented suture pull-out with suture-button(triple fixation) yields less radiological residual laxity than suture pull-out technique–for Arthroscopic reduction and internal fixation of posterior cruciate ligament avulsion fractures.

Clinical outcomes of arthroscopic suture fixation combined with loop plate vs. posterior approach open reduction and cannulated screw fixation for treating tibial avulsion fractures of the posterior cruciate ligament: a retrospective study

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