Anterograde arthroscopic fixation of avulsion fractures of the tibial eminence with a cannulated screw: five-year results

Abstract

Purpose: Fractures of the tibial eminence can be treated arthroscopically. Fixation of the fracture is usually followed by temporary immobilization. The literature suggests that only anterograde fixation with cannulated screws and washer is considered stable enough to allow for immediate mobilization and weight bearing. The goal of this study was to evaluate the 5-year results of arthroscopic reductions and anterograde fixations of the tibial eminence fracture with cannulated screws.

Type of study: Retrospective study.

Methods: Thirty-two patients were treated arthroscopically for type II, III, and IV fractures of the intercondylar eminence of the tibia. The fragments were reduced and fixed with a cannulated screw or cannulated screw and washer. The intermeniscal ligament was involved in the fracture in 29 cases, and the anterior part of the medial meniscus was involved in 3 cases, requiring a temporary shift before reduction of the fragment. Arthrotomy was not performed for reduction or fixation of the fragment. All patients began continuous passive and active motion of the involved knee and were mobilized on crutches the day after the procedure. They were allowed immediate weight bearing. The patients were followed up for 16 to 69 months.

Results: Good therapeutic results were found at follow-up. Average value for KT-1000 testing was 1.1 mm; flexion deficit was 1.2 degrees; extension deficit, 0.6 degrees; and Lysholm score, 98.8. The average treatment duration was 12 weeks. There was one case of aseptic synovitis and no other complications. In all but 1 patient, the implants were removed.

Conclusions: Arthroscopic fixation of the fracture of the intercondylar eminence of the tibia with a cannulated screw or screw and washer is a simple, safe, reproducible, and effective procedure. The fixation is stable even in type IV fractures, so that immobilization is unnecessary.