Surgical management of tibial eminence avulsion fractures: a systematic review and meta-analysis
- 19.06.2024
- Arthroscopy and Sports Medicine
Erschienen in:
- Verfasst von
- Tan Si Heng Sharon
- Kamarudin Fadzil
- Lim Andrew Kean Seng
- Hui James Hoipo
- Erschienen in
- Archives of Orthopaedic and Trauma Surgery | Ausgabe 7/2024
Abstract
Purpose
The ideal surgical management for tibial eminence avulsion fractures remains controversial with varying approach, methods of fixation and post-operative regimes reported throughout literature. The current systematic review and meta-analysis aims to compare between the different approaches, methods of fixation and post-operative regimes for tibial eminence fractures.
Methods
The systematic review was conducted according to PRISMA guidelines. A search was conducted using PubMed, MEDLINE and CINAHL databases. The keywords used were “anterior cruciate ligament”, “tibial spine” or “tibial eminence” and “fracture” or “avulsion”. All original human studies that reported the surgical outcomes of tibial eminence fractures were included. Individual patient data meta-analysis was performed.
Results
48 studies with 1367 patients were included. Arthroscopic fixation resulted in significantly greater stability in terms of anterior drawer test (p = 0.018) and Lachman’s test (p = 0.042), as compared to open fixation, though there was no significant difference for pivot shift test. There was no significant difference identified in functional scores and activity, including Lysholm score, IKDC subjective score, Tegner score and return to sports. Suture fixation had significantly increased stability compared to screw fixation, in terms of anterior drawer test (p = 0.001) and Lachman’s test (p = 0.001), though no significant difference was identified for pivot shift test. Significantly better subjective scores and return to activity were also noted for suture fixation, in terms of Lysholm score (p = 0.008), IKDC subjective score (p = 0.001) and Tegner score (p = 0.001), though no significant difference was identified for return to sports.
Conclusion
Arthroscopic and suture fixation had significantly superior outcomes when compared to open and screw fixation. Arthroscopic fixation resulted in significantly improved stability of the knee as compared to open fixation, though no significant difference was identified in terms of functional knee scores and return to activity. Suture fixation resulted in significantly improved stability of the knee and functional knee screws as compared to screw fixation.
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- Titel
- Surgical management of tibial eminence avulsion fractures: a systematic review and meta-analysis
- Verfasst von
-
Tan Si Heng Sharon
Kamarudin Fadzil
Lim Andrew Kean Seng
Hui James Hoipo
- Publikationsdatum
- 19.06.2024
- Verlag
- Springer Berlin Heidelberg
- Erschienen in
-
Archives of Orthopaedic and Trauma Surgery / Ausgabe 7/2024
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916 - DOI
- https://doi.org/10.1007/s00402-024-05318-1
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