title: Arthroscopic absorbable suture fixation for tibial spine fractures.
abstract: The purpose of this technical note and accompanying video is to describe a modified arthroscopic suture fixation technique to treat tibial spine avulsion fractures. Twenty-one patients underwent arthroscopic treatment for tibial spine avulsion with our technique; they were clinically and biomechanically evaluated at 2 years' follow-up and showed optimal clinical and radiographic outcomes. Repair with this arthroscopic technique provides a significant advantage in the treatment of type III and IV fractures of the tibial eminence by obtaining arthroscopic fixation within the substance of the anterior cruciate ligament: suture methods based on the avulsed bone fragment are technically impossible, but sutures through the base of the ligament itself provide secure fixation, reducing the risks of comminution of the fracture fragment and eliminating the time for hardware removal. This arthroscopic technique restores the length and the integrity of the anterior cruciate ligament and provides a simplified, reproducible method of treating patients, including young patients, with low hardware costs in comparison to sutures using anchors or other hardware.
authors.affiliation: Clinic of Orthopedics and Traumatology, University of Parma, Parma, Italy.
authors.forename: Michele Arcangelo
authors.initials: MA
authors.lastname: Verdano
authors.affiliation: Clinic of Orthopedics and Traumatology, University of Parma, Parma, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Pellegrini
authors.affiliation: Clinic of Orthopedics and Traumatology, University of Parma, Parma, Italy.
authors.forename: Enricomaria
authors.initials: E
authors.lastname: Lunini
authors.affiliation: Unit of Sport Medicine, Loyola University Medical Center, Chicago, Illinois, U.S.A.
authors.forename: Pietro
authors.initials: P
authors.lastname: Tonino
authors.affiliation: Clinic of Orthopedics and Traumatology, University of Parma, Parma, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Ceccarelli
references.citation: J Bone Joint Surg Br. 1982;64(4):477-80
references.pmid: 6896515
references.citation: Arthroscopy. 1994 Jun;10(3):292-5
references.pmid: 8086023
references.citation: Arthroscopy. 1994 Aug;10(4):418-23
references.pmid: 7945638
references.citation: J Bone Joint Surg Br. 1992 Nov;74(6):848-52
references.pmid: 1447245
references.citation: Arthroscopy. 2001 Nov-Dec;17(9):1007-11
references.pmid: 11694938
references.citation: J Bone Joint Surg Am. 1970 Dec;52(8):1677-84
references.pmid: 5483091
references.citation: Am J Orthop (Belle Mead NJ). 2006 Dec;35(12):558-61
references.pmid: 17243404
references.citation: Knee Surg Sports Traumatol Arthrosc. 2012 Dec;20(12):2395-8
references.pmid: 22270677
references.citation: Accid Emerg Nurs. 2004 Jul;12(3):173-5
references.pmid: 15234715
references.citation: Arthroscopy. 1993;9(4):446-50
references.pmid: 8216577
references.citation: J Bone Joint Surg Am. 1977 Dec;59(8):1111-4
references.pmid: 591548
references.citation: Knee Surg Sports Traumatol Arthrosc. 2012 May;20(5):909-15
references.pmid: 21863305