Arthroscopic fixation of tibial eminence fracture: results with 5 years of follow-up

Abstract

Introduction: avulsion fractures of the anterior cruciate ligament (ACL) are rare in adults and generally due to high-energy trauma. The objective of this paper was to evaluate clinically and functionally a series of adult patients with anterior tibial eminence fractures treated with reduction and arthroscopic fixation using “pull-out” sutures or cannulated screws.

Materials and methods: twelve patients operated on anterior tibial eminence fractures between December of 2009 and December of 2019 were analyzed in whom arthroscopic treatment was performed with “pull-out” sutures or cannulated screws. We evaluated the joint range of motion (ROM) and postoperative stability with Lachman, Pivot-Shift, and KT-1000 tests. Return to sport and functional results were evaluated with the Lysholm and IKDC scales. We analyzed radiographic consolidation and postsurgical complications.

Results: eight patients were included. Four of them were treated with cannulated screws (group 1) and four with pull-out sutures (group 2) with a mean age of twenty-nine years and a mean follow-up of seventy-eight and forty-two months (groups 1 and 2, respectively). All of them recovered the ROM, presented negative Lachman and Pivot-Shift, and KT-1000 <3 mm at last follow-up. Three out of five patients returned to pivoting sports. The Lysholm average was 98.75 (group 1) and 91.25 (group 2). The IKDC average was 85.25 (group 1) and 74.67 (group 2). All patients presented radiographic consolidation. No postoperative complications were recorded.

Conclusion: both surgical techniques were effective in restoring joint stability, achieving good functional results in the short and medium-term, and achieving radiographic consolidation in the first three postoperative months.