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

Hooper, Perry O.; Silko, Chris; Malcolm, Tennison L.; Farrow, Lutul D.

doi:10.1177/0363546517701911

Cited by 88 publications

(112 citation statements)

References 38 publications

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“… 8 , 11 , 15 Recently, suture fixation was used in arthroscopic surgery of PCL avulsion fractures, and good postoperative outcomes were reported. 5 , 17 Nonabsorbable suture fixation can have many advantages. First, suture fixation for an avulsion fracture of the tibial spine or plateau is elastic and also netlike, which is superior to rigid fixation, especially in some comminuted fracture cases 13 and in adolescents whose epiphysis is not closed.…”

Section: Discussionmentioning

confidence: 99%

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

Zhao

Chen

et al. 2020

Orthopaedic Journal of Sports Medicine

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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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Section: Discussionmentioning

confidence: 99%

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

Zhao

Chen

et al. 2020

Orthopaedic Journal of Sports Medicine

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“…Tibial avulsions of PCL are due to motor vehicle accidents in 68.4% of cases and out of these 59% are due to motor cycle accidents. 23 They are more common in countries like India and China than in the western world because use of motor cycles is more in these countries. Like ACL avulsions, PCL avulsions are also more common in children than in adults.…”

Section: Discussionmentioning

confidence: 99%

Avulsion Fractures around the Knee and their Importance

Marupaka¹,

Jakkani²,

Jampala³

et al. 2019

IJCMSR

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MATERIAL AND METHODS We collected MRI studies of 62 patients with avulsion fractures around the knee joint retrospectively from our archives. It includes 51male patients and 11female patients ranging from 14 to 73yrs of age. All the MRI evaluations in this study were done in a tertiary care hospital on a 8 channel 1.5Tesla superconducting magnet (Essenza, Siemens, Germany). PDFS FSE (TR 2800, TE 27, Slice thickness 3.5mm with a gap of 1.3mm) and T1 FSF (827/13/3.5mm/1.3mm) sagittal, STIR coronal (2990/38/4mm/1mm) and PDFS FSE axial (4280/42/4.5mm/2.0mm) sequences were performed in all cases in addition to other sequences. 8 channel knee coil was used with a field of view (FOV) of 18-20cms. No specific preparation or IV contrast was necessary in all the cases. Knee was examined in an extended relaxed position with an external rotation of about 5 o. Anterior (ACL) and posterior cruciate ligament (PCL) avulsions are assessed for associated meniscal and collateral ligament tears. Meniscal tears are evaluated with Chi square test for statistical significance Only definite meniscal tears are taken into consideration.

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“…9 . several methods were mentioned for tibial spine avulsion fixation of like cannulated screws, suture anchors 10 , and non-absorbable pull-out sutures 11. Our study verified that there is major improvement of postoperative Lysholm score. This comes in consistence with what reported by Sinha et al, 12 who confirmed that union of avulsed tibial spine in all cases, stability success and considerable improvement in Lysholm score refer to the efficiency of our technique.…”

Section: Figmentioning

confidence: 99%

Arthroscopic Fixation of Tibial Spine Avulsion in Skeletally Immature Patients by Double Tunnel Pull-out Suture Technique

Khalaf

Akl

Alnahas³

2020

Al-Azhar International Medical Journal

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

Cited by 88 publications

References 38 publications

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

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

Avulsion Fractures around the Knee and their Importance

Arthroscopic Fixation of Tibial Spine Avulsion in Skeletally Immature Patients by Double Tunnel Pull-out Suture Technique

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