Improved arthroscopic high-strength suture fixation for the treatment of posterior cruciate ligament avulsion fracture

Background: To investigate the curative effects of improved non-absorbable high-strength fixation under arthroscopy on posterior cruciate ligament (PCL) avulsion fracture. Methods: A retrospective analysis was performed on 16 cases of PCL avulsion fracture in 15 patients who underwent high-strength suture fixation under arthroscopy from December 2017 to November 2019. According to the Meyers-McKeever classification, there were 2 cases of type II and 14 cases of type III. The fracture was reduced under arthroscopy, and knotted and fixed under the anterior and medial skin of the knee joint with high-strength sutures and a button plate. Regular follow-up of the knee joint healing and stability, the range of motion and the functional recovery of affected limb was conducted. The last follow-up was completed after the button plate was taken out. The Lysholm score was used to assess the recovery situation. Results: The button plate was taken out 6-9 months (average 7.2 months) after surgery. At the last follow-up, the fractures of the 15 patients were all healed. Moreover, six patients were positive for posterior drawer test within Grade 1 and the others were negative. All patients had no knee extension limitation, and the range of knee flexion reached more than 120 degrees, with an average of (132.4 +/- 3.6)degrees. The average Lysholm score was (93.1 +/- 4.7). There were significant differences in knee flexion angle and Lysholm score at different time points after operation, p = 0.000. Conclusion: For the treatment of PCL avulsion fracture, the optimized arthroscopic high-strength suture fixation is easy to perform and repeat, and the fixation is strong and solid. The functions of the knee joint experienced good recovery after the surgery.