Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original ArticleOpen Screw Fixation Versus Arthroscopic Suture Fixation of Tibial Posterior Cruciate Ligament Avulsion Injuries: A Mechanical Comparison
Section snippets
Specimen Preparation
We used 20 fresh-frozen undamaged human cadaveric knees (10 pairs), all male, ranging in age from 44 to 63 years, in this study. The femur was cut 20 cm and the tibia was cut 30 cm from the joint line. The iliotibial tract was incised to the mid thigh, and the popliteus musculotendinous unit and the joint capsule were left intact. The fibula was secured to the tibia to simulate the restraint provided by the interosseous membrane. The knees were stored at −20°C and, before testing, were thawed
Results
One knee in each group had a fixation failure detected by direct visual inspection after the repaired condition tests. Table 1, Table 2 show the mean posterior displacement and stiffness, respectively, for groups A and B for the 3 conditions. Analysis of variance showed no differences between these 2 groups in terms of posterior displacement (P = .229) and stiffness (P = .285).
Discussion
Recently, arthroscopic techniques to treat PCL tibial avulsion fracture fixation have become a reality. In the beginning, there was percutaneous screw fixation described by Martinez-Moreno and Blanco-Blanco,17 followed by proposals for cannulated screw fixation by Choi and Kim24 and Littlejohn and Geissler,18 as well as K-wire percutaneous fixation described by Deehan and Pinczewski25 (used on small fragments), and finally an evolution to arthroscopic suture techniques, as reported by Kim et
Conclusions
We have reported an arthroscopic suture technique for fixation of PCL tibial bony avulsion fractures. Our technique is as reliable as open screw fixation for PCL tibial bony avulsion fractures with respect to initial fixation in a human cadaveric model.
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The authors report no conflict of interest.