Arthroscopic Fixation of Displaced Tibial Eminence Fractures: A New Growth Plate–Sparing Method

Abstract

Fractures of the tibial eminence can be treated arthroscopically. Numerous ways to attach an anterior cruciate ligament avulsion from the tibial eminence have been designed. This report describes a new physis-sparing reduction and fixation technique using an anchor passing nonabsorbable braided sutures through the substance of the anterior cruciate ligament, holding the avulsed bone fragment by tying a locking knot. This study was performed to evaluate a consecutive group of patients who underwent reduction and fixation of tibial avulsion fractures fixed with an anchor with sutures. The evaluation was performed by use of objective and subjective International Knee Documentation Committee (IKDC) scores, KT-1000 measurement (MEDmetric, San Diego, CA), Lachman and pivot-shift tests, and Lysholm score. The global IKDC objective score was normal (A) in 4 knees and nearly normal (B) in 3, without extension or flexion limitations. The mean IKDC subjective score was 92 out of 100 (range, 86 to 98). The results of the anterior drawer, Lachman, and pivot-shift tests were negative. The mean Lysholm score improved from 29 to 94. The mean side-to-side difference in anterior tibial translation was 2 mm (range, 1 to 3 mm). Arthroscopic stabilization by use of an anchor with sutures was possible in all cases of tibial spine fracture. We were able to obtain excellent results in this series using this fixation method. Level IV, therapeutic case series.