Clinical and Radiological Outcomes Following Arthroscopic Dual Tibial Tunnel Double Sutures Knot-bump Fixation Technique for Acute Displaced Posterior Cruciate Ligament Avulsion Fractures

Background: Many fixation options (Open and arthroscopic) are described for Posterior Cruciate Ligament avulsion(PCL) fractures. In this retrospective series, we evaluated functional and radiographic outcomes following arthroscopicdual tunnel double sutures knot bump technique for acute PCL tibial end avulsion fractures.Methods: 23 patients with acute PCL avulsion fractures who were operated between 2009 and 2016 by Arthroscopicdual tunnel double sutures technique at a minimum of two years of follow-up were included in the study. Clinicaloutcomes were measured by Lysholm and International Knee Documentation Committee (IKDC) scores. Theradiographic assessment included union status of fracture, the grade of osteoarthritis, and knee laxity.Results: The mean age of patients was 34.43 years (range, 18-54 years) with a mean follow up of 52.8 months(36-94 months). At the final follow-up, mean subjective IKDC and Lysholm scores were 82.71 (range, 65.5-100) and95.82 (range, 81-100), respectively. On the IKDC objective scale, ten patients (43.47%) were graded as A, 11 patients[47.82%] as grade B, and two patients as grade C [8.7%]. On kneeling stress view, knee laxity in 21 patients (91.3%)was graded 0, and the remaining two as grade I and II. The fracture had united in all cases by the end of 12 weeksexcept one which had non-union. 21 patients had no evidence of osteoarthritis at the final follow up.Conclusion: Arthroscopic dual tibial tunnel double suture knot bump technique for acute PCL avulsion fractures is asafe and reliable technique that restores the stability and function of the knee.Level of evidence: IV

Keywords:

Arthroscopy , Avulsion , Fractures , Posterior cruciate ligament , Sutures