Functional outcome in tibial spine fracture treated with arthroscopic pull through suture technique

Abstract

Introduction: Various fixations techniques are available for fixation of tibial spine avulsion fracture. Arthroscopic assisted fixation can be achieved by screw fixation, pull through sutures, and using suture anchors. We conducted a prospective study to analyze the results of arthroscopic assisted pull through suture technique for treatment of tibial spine avulsion. Materials and Methods: Ten patients with displaced tibial spine avulsion fractures without other associated ligament injuries were included in the study. Ten patients (2 female and 8 male) with a mean age of 29.2 years (19-42 years) underwent arthroscopic assisted fixation with pull through suture technique. The postoperative results were analyzed using clinical tests, radiological evaluation and International Knee Documentation Committee (IKDC), Lysholm score and Tegner activity level. Observations and Results: The mean follow-up period was 21.7 months. We evaluated all patients at 18 months after the surgery. Radiographs showed that all fracture healed anatomically at an average duration of 3 months after surgery. At the final follow-up, all patients reported no symptoms of instability, such as giving – way episodes, clinical signs of anterior cruciate ligament deficiency were negative. The mean Lysholm score was 96.9 (range 91-100), mean IKDC score was 87.9 (range 83-93), and all patients achieved their pre injury Tegner activity levels. One patient had postoperative arthrofibrosis with the loss of terminal extension of 5° which responded to arthroscopic adhesiolysis and physiotherapy. We had no case of infection. Conclusion: Arthroscopic suture pull through a technique for tibial spine fracture is a minimally invasive technique with good functional and radiological results with a lesser risk of arthrofibrosis, infection, and need for hardware removal.