Arthroscopic Suture Fixation of Tibial Eminence Avulsion Fractures

Purpose: 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 core, 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. Level of Evidence: Level IV, therapeutic case series.