Open Screw Fixation Versus Arthroscopic Suture Fixation of Tibial Posterior Cruciate Ligament Avulsion Injuries: A Mechanical Comparison

Sasaki, Sandra Umeda; Albuquerque, Roberto Freire da Mota e; Amatuzzi, Marco Martins; Pereira, César Augusto Martins

doi:10.1016/j.arthro.2007.06.012

Cited by 52 publications

(44 citation statements)

References 29 publications

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“…The application of the open posteromedial approach, which avoids nerves and blood vessels, has the potential to provide a clearer view of the broken ends of the fractured bone, and allows for complete fracture reduction and successful fixation of the bone fracture fragments. In 2007, Sasaki et al (18) examined 20 knee specimens to compare the mechanical properties of tibias with PCL avulsion fractures that were fixed with ORIF or arthroscopic sutures; they observed no significant difference in tibial backward shift between the two treatments. It has become apparent that the open posteromedial approach has advantages for primary-level hospitals that have difficulties in obtaining access to arthroscopic techniques.…”

Section: Discussionmentioning

confidence: 99%

Treatment of posterior cruciate ligament avulsion fractures of the tibia using a toothed plate and hollow lag screw

Chen¹,

Luo²,

Chen³

et al. 2016

smedj

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INTRODUCTIONTo investigate the feasibility and clinical efficacy of using a toothed plate and hollow lag screw in the surgical treatment of posterior cruciate ligament (PCL) avulsion fractures of the tibia. METHODSA total of 21 patients were treated with open reduction and internal fixation using a toothed plate and hollow lag screw, through a posteromedial approach using an inverted L-shaped incision. The patients were allowed appropriate functional exercises, including knee flexion and extension, after removal of the plaster at postoperative weeks 3-6. The follow-up period was between six months and two years. RESULTSThis was a retrospective study of patients with PCL avulsion fractures of the tibia caused by road traffic accidents (n = 9), sports-related injuries (n = 6), falls (n = 5) and machinery-related injuries (n = 1). 20 patients presented with fresh fractures and one with an old fracture. The patients (13 men, eight women) had a mean age of 41.5 (range 19-72) years. Anatomical reduction of the fracture and satisfactory fixation were achieved in all 21 patients. Bony union was achieved in all patients at 8-12 weeks after surgery. Six months after surgery, knee flexion was 121.9° ± 10.4° and extension was 0°. According to the Lysholm Knee Scoring Scale, 19 patients were rated as 'excellent' and two as 'good'. CONCLUSIONThe use of a toothed plate and hollow lag screw could be a simple and reliable approach for PCL avulsion fractures of the tibia. Patients achieved good knee function after surgery.

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Section: Discussionmentioning

confidence: 99%

Treatment of posterior cruciate ligament avulsion fractures of the tibia using a toothed plate and hollow lag screw

Chen¹,

Luo²,

Chen³

et al. 2016

smedj

View full text Add to dashboard Cite

show abstract

“…In the present study, for comminuted fractures or smaller and thinner fragments, a washer was added with screw implantation because the washer could gather and tightly lock the comminuted fragments, expand the area of fixation, intensify the internal fixation strength and prevent the failure of fixation [19]. The same technology should be considered for cases that require screw removal after fracture healing, so that the whole therapeutic process and minimal invasiveness can be reflected thoroughly and optimum knee function can be obtained.…”

Section: Discussionmentioning

confidence: 92%

“…There [15,19] have reported that minimally invasive therapy of arthroscopic-assisted screw fixation has achieved success in the treatment of PCL tibial avulsion fractures, and they feel that this technology has comparable stability with open reduction and internal screw fixation. It is well known that microendoscopic discectomy is the classic minimally invasive surgical technology for lumbar disc herniation.…”

Section: Discussionmentioning

confidence: 94%

Effects of microendoscopy-assisted reduction and screw fixation through a single mini-incision on posterior cruciate ligament tibial avulsion fracture

Chen

Tang

Kang

et al. 2011

Arch Orthop Trauma Surg

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“…Sasaki et al, concluded that the technique of arthroscopic PCL tibial avulsion fixation is as promising as open screw fixation; however, it needs more surgical experience and maintains long learning curve (4). for hardware removal (5).…”

Section: Learning Curve Of Arthroscopic Pcl Avulsion Fixation Surgerymentioning

confidence: 99%

Are Arthroscopic PCL Avulsion Fixation and its Long Learning Curve Morally Justified When Other Surgical Approaches are Valid? An Ethical Issue in Surgical Research

Omrani¹,

Kazemian²,

Rasi³

et al. 2017

J Orthop Spine Trauma

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There are controversial disputes regarding the ethical concerns for arthroscopic posterior cruciate ligament (PCL) avulsion fixation accompanied by various complications and difficulties. Firstly, this procedure maintains long learning curve, and it is still in a cast of dilemma if this procedure is justified, when a surgeon should undergo a considerable time and efforts in order to acquire enough experience regarding this novel procedure. Secondly, when stable fixation is not achieved, one may need to shift to open surgery; the issue arises when surgeon terminates the surgery just with somewhat fixation because he does not want to demonstrate any sign of weakness regarding his surgical skills. And finally, there are specific considerations that should be taken into account in the informed consent for an innovative surgery. Here the study discusses these terms in the faiths of fashioning a catalyst for further discussions.

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Open Screw Fixation Versus Arthroscopic Suture Fixation of Tibial Posterior Cruciate Ligament Avulsion Injuries: A Mechanical Comparison

Cited by 52 publications

References 29 publications

Treatment of posterior cruciate ligament avulsion fractures of the tibia using a toothed plate and hollow lag screw

Treatment of posterior cruciate ligament avulsion fractures of the tibia using a toothed plate and hollow lag screw

Effects of microendoscopy-assisted reduction and screw fixation through a single mini-incision on posterior cruciate ligament tibial avulsion fracture

Are Arthroscopic PCL Avulsion Fixation and its Long Learning Curve Morally Justified When Other Surgical Approaches are Valid? An Ethical Issue in Surgical Research

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