title: Novel arthroscopic fixation method for anterior cruciate ligament tibial avulsion fracture with accompanying detachment of the anterior horn of the lateral meniscus: three-point suture fixation.
abstract: OBJECTIVE
  The purpose of this study is to present and evaluate a new arthroscopic technique using three-point suture fixation for anterior cruciate ligament (ACL) tibial avulsion fracture with accompanying detachment of the anterior horn of the lateral meniscus.
  
  
  METHODS
  Eleven patients with a diagnosis of ACL tibial avulsion fracture underwent arthroscopic suture fixation from January 2007 to December 2009. Out of the 11 patients, six had cases of ACL tibial avulsion fractures (four were type III and two were type IV) with accompanying detachment of the anterior horn of the lateral meniscus and were treated using three-point suture fixation. The patients were followed up and evaluated according to Lysholm scores, International Knee Documentation Committee (IKDC) subjective scores, Tegner activity level scales, anterior drawer testing and KT-2000 arthrometer testing.
  
  
  RESULTS
  All patients were followed up for more than 2 years (range 25-40 months). The fracture fragments were united at a mean of 10.3 weeks (range 8-13). All patients were negative for the Lachman test and the anterior drawer test and had < 3 mm side-to-side difference with the KT-2000 arthrometer. The postoperative mean Lysholm score improved to 98 (range 96-100, P < 0.05). The postoperative mean IKDC subjective score was 93.3 (range 91-98, P < 0.05). The median Tegner score improved from 2.5 (range 2-3) to 8.5 (range 8-9) postoperatively (P < 0.05). The type of avulsion fracture (III or IV) did not significantly impact clinical results (Lysholm score, IKDC score, Tegner activity level, P > 0.05).
  
  
  CONCLUSIONS
  ACL avulsion fractures with accompanying detachment of the anterior horn of the lateral meniscus should be treated as another type of ACL avulsion fracture. Arthroscopic treatment using the three-point suture fixation technique is effective for this type of ACL avulsion fracture and can restore the function and stability of the knee joint.
authors: Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Gu, Seoul 135-710, South Korea.
authors: Ki-Mo
authors: KM
authors: Jang
authors: Ji-Hoon
authors: JH
authors: Bae
authors: Jae Gyoon
authors: JG
authors: Kim
authors: Joon Ho
authors: JH
authors: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000503:physiopathology / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy / Q000379:methods; D006801:Humans; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery*; D008875:Middle Aged; D012189:Retrospective Studies; D013536:Suture Techniques; D013978:Tibial Fractures / Q000150:complications / Q000601:surgery*; D000070600:Tibial Meniscus Injuries; D055815:Young Adult