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. 2020 May;11(Suppl 3):S362-S367.
doi: 10.1016/j.jcot.2019.06.020. Epub 2019 Jun 27.

Clinical experience with arthroscopic suture pull technique in isolated PCL avulsion injuries

Ravindra Lamoria  1 , Divyanshu Goyal  1 , Mahesh Bansal  1 , Sanjeev Kaler  1 , Rahul Upadhyay  1
Affiliations

Clinical experience with arthroscopic suture pull technique in isolated PCL avulsion injuries

Ravindra Lamoria et al. J Clin Orthop Trauma. 2020 May.

Abstract

Objective: to assess twenty two cases of isolated PCL avulsion fractures from tibial insertion, arthroscopically treated with suture pull technique, and to evaluate achieved clinical outcomes in terms of radiographic laxometry (objective) and Lysholm scale (subjective).

Material and method: Study includes 22 cases operated between April 2014 and March 2017. Patients less than 18 years old, presentation after 3 weeks of injury, concomitant injury in the same limb, with open wounds or with comminuted avulsed fragment were excluded from the study. All cases were MRI proven. All arthroscopic suture fixation technique was used in all cases. Follow up was done at 3 weeks, 6 weeks, 3 months, 6 months and 12 months. Mean follow up was one year. Subjective complaints, Knee flexion, Lysholm score and stress radiographs were noted.

Results: Average Lysholm score was 96.3. Seventeen patients had excellent results and Five had good results based on Lysholm scores. In two patients, grade 2 laxity (5-10 mm) was present on stress radiographs but there were no clinical complaints. All patients achieved osseous union and had no functional limitation. Three Patients developed arthrofibrosis initially but gained functional range later.

Conclusion: Arthroscopic suture fixation method for PCL avulsion fracture from tibia is a good and safe method of choice for fixation.

Keywords: Arthroscopic suture fixation; Isolated PCL avulsion fracture; Knee; Knee arthroscopy; Lysholm score.

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Figures

Fig. 1
Fig. 1
a- AP radiograph of knee joint showing avulsed fragment. b-lateral radiograph showing avulsed fragment from tibia. c- MRI showing PCL avulsion from Tibia. d- 3D CT showing avulsed fragment from tibia.
Fig. 2
Fig. 2
A- Black arrow shows avulsed fragment from its bed Blue arrow points towards the fracture bed. B- curettage and preparation of the fracture bed. C- beath pin passed through the fracture bed using PCL zig.
Fig. 3
Fig. 3
Immediate post op radiograph showing fixation of avulsed fragment on its bed and tied anteriorly on tibia using suture disc.
Fig. 4
Fig. 4
Line diagram depicting suture pull technique – posterior view.
Fig. 5
Fig. 5
Line diagram depicting suture pull technique – Lateral view.
Fig. 6
Fig. 6
Osseous union at 3 months follow up. a – lateral view. b – AP view.
See this image and copyright information in PMC

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