Abstract
BackgroundTibial intercondylar eminence avulsion fractures occur primarily in adolescents and young adults. However, the incidence of such fractures is increasing in adults, concurrent with an increase in sports injuries and traffic accidents. This study describes the fixation-based double-row anchor suture-bridge technique, a novel technique for treating tibial intercondylar eminence fractures in adults; and evaluates its preliminary clinical outcomes.MethodsA retrospective evaluation of adult patients with tibial intercondylar eminence fractures treated at our institution from June 2016 to June 2018 was conducted. Seven such patients, treated with the anchor suture-bridge technique, were included. All patients were assessed for knee joint range of motion (ROM), Lysholm knee score, International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form score, Tegner activity score pre-surgery, and the healing of the fracture at 3, 6 and 12 months minimal post-surgery follow-up.ResultsPatients were followed for a mean of 12.43 months (range 9-15 months). By the final follow-up, all fractures had fully healed. The mean Lysholm score improved from 27.86 (range, 2 to 54) pre-surgery to 88.14 (range, 81 to 100) 3 months post-surgery (p < 0.05). Similarly, the mean IKDC score improved from 48.86 (range, 43 to 55) to 84.29 (range, 75 to 90) (P < 0.05); and the mean Tegner activity score improved from 1.71 (range, 0 to 4) to 3.29 (range, 2 to 4) (p < 0.05). Furthermore, knee joint ROM, Lysholm scores, IKDC scores, and Tegner activity scores displayed excellent outcomes at the 6 and 12 months minimal follow-up.ConclusionThe arthroscopic anchor suture-bridge technique is a valid and secure method for achieving effective fixation of tibial intercondylar eminence fractures in adults.
Highlights
Tibial intercondylar eminence avulsion fractures occur primarily in adolescents and young adults
An avulsion fracture of the tibial intercondylar eminence is regarded as a special type of anterior cruciate ligament (ACL) injury, and its treatment depends on the extent of the fracture’s displacement
According to the modified Meyers-McKeeverZaricznyj classification [3, 4], tibial intercondylar eminence fractures can be classified into four types: type I without displacement or slight displacement of fracture fragments; type II with 1/3-1/2 displacement of the anterior edge of avulsed fracture fragments, but no obvious displacement of the posterior edge; type III with complete displacement of fracture fragments; and type IV with comminuted avulsion fractures
Summary
Tibial intercondylar eminence avulsion fractures occur primarily in adolescents and young adults. The incidence of such fractures is increasing in adults, concurrent with an increase in sports injuries and traffic accidents. This study describes the fixation-based double-row anchor suture-bridge technique, a novel technique for treating tibial intercondylar eminence fractures in adults; and evaluates its preliminary clinical outcomes. The incidence of such isolated fractures has gradually increased in recent decades with an increase in sports injuries and traffic accidents [1, 2]. An avulsion fracture of the tibial intercondylar eminence is regarded as a special type of anterior cruciate ligament (ACL) injury, and its treatment depends on the extent of the fracture’s displacement. Type I fractures are treated conservatively by brace fixation at the extension position of the knee joint. Anatomical reduction and stable internal fixation are essential for the functional recovery of the knee joint regardless of the patients’ age, especially for patients with cartilage, meniscus or collateral ligament injuries [7]
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