Arthroscopic treatment of tibial spine fracture in adult with a simple modified suture fixation technique

Objectives: Extreme tensile force to the anterior cruciate ligament (ACL) can cause an avulsion of the tibial eminence which may lead to malunion or nonunion resulting in pain, flexion deformity, and instability of the knee. Since the injury is generally regarded as something equivalent to the ACL injury, the treatment requires anatomic reduction of the fragment and preservation of the stability of the knee. The aim of this study was to test our experience in the treatment of displaced tibial eminence fractures with a simple modified suture fixation technique. Methods: Between January 2012 and June 2014, five adults with Type II or Type III anterior tibial eminence fractures were treated surgically. All patients were twice evaluated not only before the surgical treatment but also two years after the surgery, including clinical and radiographic outcomes. Results: Two years after the surgery, we did not find instability in any of the patients by physical examination. The average scores of Lysholm functional scale and the International Knee Documentation Committee (IKDC) subjective score were improved greatly after the surgery. The range of motion (ROM) of the injured knees also was identical to healthy sides two years later. Conclusions: The findings indicate that the presented arthroscopic technique provides good stability and preserves the function of the injured knee in the mid-term.