Arthroscopic Fixation with Knotless Suture Anchorage in Anterior Tibial Spine Fractures in Pediatric and Adolescent Patients
DOI:
https://doi.org/10.63403/re.v33i2.484Keywords:
Arthroscopy, Suture, Knotless, Tibial spineAbstract
Introduction: anterior tibial spine avulsion fractures are uncommon intra-articular injuries, but clinically significant, particularly in pediatric and adolescent patients with open physes. Surgical treatment aims to achieve anatomic reduction and stable fixation while preserving the physis to prevent growth disturbances. Arthroscopy-assisted internal fixation has gained increasing popularity. However, there is limited clinical evidence regarding the use of knotless suture anchors in displaced fractures.
Objective: to presents the clinical, functional, and imaging outcomes of a series of pediatric and adolescent patients treated with knotless suture anchor fixation under arthroscopic guidance.
Materials and methods: a retrospective case series of 17 patients younger than 23 years with Meyer and McKeever type II–IV tibial spine fractures was conducted. All were treated by a single surgeon between February 2023 and May 2024, with a minimum follow-up of 12 months. Functional outcomes were assessed using the Lysholm, Tegner, and IKDC scores. Time to bone healing was evaluated using radiographs and MRI, and complications were recorded.
Results: the mean age was 13.6 years, with 76% male patients. The primary mechanism of injury was sports-related (76%). No loss of reduction or malunion was observed; bone healing was achieved in 100% of cases (mean: 4 weeks). Functional outcomes were excellent: Lysholm 97.7 (95-100), Tegner 8.4 (5.5-9), and IKDC 82.8 (79-87). The mean time to return to sports was 8.3 months. Complications occurred in 23% of cases, all corresponding to arthrofibrosis (n=3).
Conclusion: arthroscopic fixation of displaced anterior tibial spine fractures using knotless suture anchors in pediatric and adolescent patients shows excellent clinical and functional outcomes, with high healing rates and low morbidity.
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Copyright (c) 2026 Luciano Patthauer, Gonzalo J. Blanco Odena, Nicole Albornoz, José C. Barbier, Marcelo Blanco, Jorge P. Batista, Julio J. Masquijo
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