A minimally invasive postero-medial approach with suture anchors for isolated tibial avulsion fracture of the posterior cruciate ligament

Abstract

Background and purpose: The optimal surgical treatment of isolated tibial avulsion fractures of the posterior cruciate ligament (PCL) remains controversial. The purpose of this study was to report preliminary results of a novel surgical approach to isolated PCL avulsion fractures by a minimally invasive postero-medial approach with suture anchors.

Patients and methods: Outcomes were retrospectively analyzed in 16 patients with isolated tibial avulsion fractures of the PCL treated with this approach.

Results: Length of surgery ranged from 20 to 40 min (mean, 28 min). Patients were followed-up for 4 to 36 months (mean, 18 months). X-rays showed that satisfactory reduction and bony healing was achieved in all cases. Excellent and good outcomes were reported by 15 and 1 patient respectively with the Lysholm score system.

Conclusions: This minimally invasive postero-medial approach, with minimal but sufficient exposure and effective fixation, may be suitable for the treatment of isolated tibial avulsion fractures of the PCL. More detailed and longer follow up of these patients is needed before definitive conclusions on efficacy can be reached.