Arthroscopic suture fixation of tibial eminence avulsion fractures.
OBJECTIVE
This study presents the clinical results of a procedure for treating tibial eminence fractures of the anterior cruciate ligament (ACL) using arthroscopic reduction and No. 5 Ethibond sutures (Ethicon, Somerville, NJ).


METHODS
This prospective study analyzed 36 patients who underwent arthroscopic reduction and suture fixation for image-proven ACL avulsion fractures of the tibial eminence. The classification of Meyers and McKeever identified 6 type II, 16 type III, and 14 type IV fractures. The mean follow-up period was 34.4 months (range, 24 to 91 months). Follow-up assessment included Lysholm knee score, Tegner activity score, International Knee Documentation Committee (IKDC) score, and KT-1000 arthrometer (MEDmetric, San Diego, CA) and radiographic evaluation.


RESULTS
The mean preoperative Lysholm score in the 36 knees was 38 (range, 28 to 54); the mean postoperative Lysholm score was 98 (range, 83 to 100). The mean preinjury and preoperative Tegner scores in the 36 knees were 7.5 +/- 1.5 (range, 5 to 9) and 3 +/- 1.7 (range, 2 to 5), respectively. The mean postoperative Tegner score was 7.3 +/- 1.7 (range, 5 to 9). At final follow-up, 34 patients (94.5%) were classified by IKDC score as normal or nearly normal (grade A or B). The IKDC classification was abnormal (grade C) in 2 patients (5.5%). All 36 fractures achieved union within 3 months. No significant complications, such as arthrofibrosis, loss of initial fixation, or wound infection, were noted.


CONCLUSIONS
Treating ACL avulsion fracture by arthroscopic suture fixation by use of 4 No. 5 Ethibond sutures can restore ACL length, stabilize fragments, promote early motion, and minimize morbidity.


METHODS
Level IV, therapeutic case series.
Huang
Tsan-Wen
TW
Department of Orthopedic Surgery, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan, Republic of China.
Hsu
Kuo-Yao
KY
Cheng
Chun-Ying
CY
Chen
Lih-Huei
LH
Wang
Ching-Jen
CJ
Chan
Yi-Sheng
YS
Chen
Wen-Jer
WJ
D000328:Adult; D016118:Anterior Cruciate Ligament / Q000503:physiopathology; D001182:Arthroscopy / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery; D017846:Longitudinal Ligaments / Q000503:physiopathology; D008875:Middle Aged; D009984:Orthopedic Fixation Devices; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology; D016119:Posterior Cruciate Ligament / Q000503:physiopathology; D011446:Prospective Studies; D016059:Range of Motion, Articular; D013536:Suture Techniques; D013977:Tibia / Q000601:surgery; D013978:Tibial Fractures / Q000534:rehabilitation / Q000601:surgery*