Skip to main content

Advertisement

Log in

Arthroscopic fixation of ACL avulsion fracture in the Saint Paul Hospital: a review of treatment outcomes

  • Original Article • KNEE - MEDICAL STATISTICS
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

A Correction to this article was published on 06 July 2019

This article has been updated

Abstract

The purpose of this research is to evaluate the results of arthroscopic suture fixation with fiber wires used as treatment for ACL avulsion fracture, and to determine how effective such a technique is when it comes to restoring of knee function. This prospective study involves 28 patients, who underwent arthroscopic fixation of displaced ACL avulsion fractures at Saint Paul Hospital (Hanoi) from January 2014 to March 2018. The first 3 weeks were not marked with any abnormalities associated with postoperative sutures and hematomas; infectious complications were not detected either. Postoperative displacement of fracture fragments did not take place among the patients involved in the study. At the 3-month follow-up, the average IKDC score was 90.7 (range 76–100), and the average Lysholm score was 93.6 (range 82–100). The percentage of excellent scores was 42.9% (12 patients), good scores accounted for 50% (14 patients), while fair/poor scores accounted for 3.6% each (one patient on each score). The percentage of excellent/good scores was 92.9% in total. This study shows that ACL avulsion fracture can be treated effectively by arthroscopic suture fixation with fiber wires. In fact, this technique may restore knee function and stability.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

Change history

  • 06 July 2019

    The original version of this article unfortunately contained a mistake. One affiliation was incorrect.

References

  1. Millet PJ, Pennock AT, Sterett WI, Steadman JR (2004) Early ACL reconstruction in combined ACL–MCL injuries –. J Knee Surg 17(2):94–98

    Article  Google Scholar 

  2. Fu FH, Karlsson J (2010) A long journey to be anatomic. Knee Surg Sports Traumatol Arthrosc 18(9):1151–1153

    Article  Google Scholar 

  3. Gans I, Baldwin KD, Ganley TJ (2014) Treatment and management outcomes of tibial eminence fractures in pediatric patients: a systematic review. Am J Sports Med 42(7):1743–1750

    Article  Google Scholar 

  4. Frolke JP, Oskam J, Vierhout PA (1998) Primary reconstruction of the medial collateral ligament in combined injury of the medial collateral and anterior cruciate ligaments short-term results. Knee Surg Sports Traumatol Arthrosc 6(2):103–106

    Article  CAS  Google Scholar 

  5. Meyers MH, McKeever FM (1970) Fracture of the intercondylar eminence of the tibia. J Bone Joint Surg Am 52:1677–1684

    Article  CAS  Google Scholar 

  6. Zaricznyj B (1977) Avulsion fracture of the tibial eminence: treatment by open reduction and pinning. J Bone Joint Surg Am 59:1111–1114

    Article  CAS  Google Scholar 

  7. LaFrance RM, Giordano B, Goldblatt J, Voloshin I, Maloney M (2010) Pediatric tibial eminence fractures: evaluation and management. J Am Acad Orthop Surg 18:395–405

    Article  Google Scholar 

  8. Lubowitz JH, Elson WS, Guttmann D (2005) Part II: Arthroscopic treatment of tibial plateau fractures: Intercondylar eminence avulsion fractures. Arthroscopy 21:86–92

    Article  Google Scholar 

  9. Shelbourne KD, Urch SE, Freeman H (2011) Outcomes after arthroscopic excision of the bony prominence in the treatment of tibial spine avulsion fractures. Arthroscopy 27:784–791

    Article  Google Scholar 

  10. Koukoulias NE, Germanou E, Lola D, Papavasiliou AV, Papastergiou SG (2012) Clinical outcome of arthroscopic suture fixation for tibial eminence fractures in adults. Arthroscopy 28:1472–1480

    Article  Google Scholar 

  11. Jang K-M, Bae J-H, Kim JG, Wang JH (2013) Novel arthroscopic fixation method for anterior cruciate ligament tibial avulsion fracture with accompanying detachment of the anterior horn of the lateral meniscus: three-point suture fixation. Injury 44:1028–1032

    Article  Google Scholar 

  12. White EA, Patel DB, Matcuk GR, Forrester DM, Lundquist RB, Hatch GF, Vangsness CT, Gottsegen CJ (2013) Cruciate ligament avulsion fractures: anatomy, biomechanics, injury patterns, and approach to management. Emerg Radiol 20:429–440

    Article  Google Scholar 

  13. Ezechieli M, Schafer M, Becher C, Dratzidis A, Glaab R, Ryf C, Hurschler C, Ettinger M (2013) Biomechanical comparison of different fixation techniques for reconstruction of tibial avulsion fractures of the anterior cruciate ligament. Int Orthop 37:919–923

    Article  Google Scholar 

  14. Lu X-W, Hu X-P, Jin C, Zhu T, Ding Y, Dai L-Y (2010) Reduction and fixation of the avulsion fracture of the tibial eminence using mini-open technique. Knee Surg Sports Traumatol Arthrosc 18:1476–1480

    Article  Google Scholar 

  15. Pan R-Y, Yang J-J, Chang J-H, Shen H-C, Lin L-C, Lian Y-T (2012) Clinical outcome of arthroscopic fixation of anterior tibial eminence avulsion fractures in skeletally mature patients: a comparison of suture and screw fixation technique. J Trauma Acute Care Surg 72:E88–E93

    Article  Google Scholar 

  16. Boutsiadis A, Karataglis D, Agathangelidis F, Ditsios K, Papadopoulos P (2014) Arthroscopic 4-point suture fixation of anterior cruciate ligament tibial avulsion fractures. Arthrosc Tech 3(6):e683–e687

    Article  Google Scholar 

  17. Verdano MA, Pellegrini A, Lunini E, Tonino P, Ceccarelli F (2013) Arthroscopic absorbable suture fixation for tibial spine fractures. Arthrosc Tech 3:e45–e48

    Article  Google Scholar 

  18. Ahn JH, Yoo JC (2005) Clinical outcome of arthroscopic reduction and suture for displaced acute and chronic tibial spine fractures. Knee Surg Sports Traumatol Arthrosc 13:116–121

    Article  Google Scholar 

  19. Song EK, Seon JK, Park SJ, Yoon TR (2009) Clinical outcome of avulsion fracture of the anterior cruciate ligament between children and adults. J Pediatr Orthop B 18:335–338

    Article  Google Scholar 

  20. Seon JK, Park SJ, Lee KB, Gadikota HR, Kozanek M, Oh LS, Hariri S, Song EK (2009) A clinical comparison of screw and suture fixation of anterior cruciate ligament tibial avulsion fractures. Am J Sports Med 37:2334–2339

    Article  Google Scholar 

  21. Jadhav U, Gotecha D (2017) Fixation of anterior cruciate ligament avulsion fractures with arthroscopic suture bridge technique. Saudi J Sports Med 17(1):22–26

    Article  Google Scholar 

  22. Kumar KM, Kerakkanava S (2017) ACL avulsion managed with pullout suture technique-a prospective study. Indian J Orthop Surg 3(4):335–338

    Google Scholar 

  23. Kobayashi S, Harato K, Udagawa K, Masumoto K, Masashi J, Toyoda T, Niki Y (2018) Arthroscopic treatment of tibial eminence avulsion fracture with suture tensioning technique. Arthrosc Tech 7(3):251–256

    Article  Google Scholar 

  24. Irrgang JJ, Anderson AF, Boland AL, Harner CD, Kurosaka M, Neyret P et al (2001) Development and validation of the international knee documentation committee subjective knee form. Am J Sports Med 29:600–613

    Article  CAS  Google Scholar 

  25. Fu SN, Chan YH (2011) Translation and validation of Chinese version of International Knee Documentation Committee subjective knee form. Disabil Rehabil 33:1186–1189

    Article  Google Scholar 

  26. Briggs KK, Lysholm J, Tegner Y, Rodkey WG, Kocher MS, Steadman JR (2009) The reliability, validity, and responsiveness of the Lysholm score and Tegner activity scale for anterior cruciate ligament injuries of the knee: 25 years later. Am J Sports Med 37:890–897

    Article  Google Scholar 

  27. In Y, Kim JM, Woo YK, Choi NY, Moon CW, Kim MW (2008) Arthroscopic fixation of ACL avulsion fractures using bio absorbable suture anchors. Knee Surg Sports Traumatol Arthrosc 16:286–289

    Article  Google Scholar 

  28. Sun K, Gai PZ, Xu Q, Liu JZ, Yu TB, Tian SQ (2008) A study of three different procedures for avulsion fracture of tibial intercondylar eminence. Chin J Surg 46(4):270–273

    PubMed  Google Scholar 

  29. Fabricant PD, Osbahr DC, Green DW (2011) Management of a rare complication after screw fixation of a pediatric tibial spine avulsion fracture: a case report with follow up to skeletal maturity. J Orthop Trauma 25(12):1159

    Article  Google Scholar 

  30. Kieser DC, Gwynne JD, Dreyer S (2011) Displaced tibial intercondylar eminence fractures. J Orthop Surg (Hong Kong) 19(3):292–296

    Article  Google Scholar 

  31. Huang TW, Hsu KY, Cheng C, Chen LH, Wang CJ, Chan YS, Chen WJ (2008) Arthroscopic suture fixation of tibial eminence avulsion fractures (36 cases). Arthroscopy 24:1232–1238

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tran Trung Dung.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dung, T.T., Du, H.G., Long, N.H. et al. Arthroscopic fixation of ACL avulsion fracture in the Saint Paul Hospital: a review of treatment outcomes. Eur J Orthop Surg Traumatol 29, 1485–1491 (2019). https://doi.org/10.1007/s00590-019-02466-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00590-019-02466-8

Keywords

Navigation