Arthroscopic management of tibial eminence fracture: a review of treatment outcome
Keywords:Tibial eminence fracture, Arthroscopic technique, Pull-through sutures, Outcomes
In this study outcomes of arthroscopic management of tibial eminence fracture have been described. We conducted a study of 15 patients of ACL avulsion fractures especially Meyer and Mckeever type II and III treated arthroscopically by pull through sutures. Outcome measures were assessed through International Knee Documentation Committee (IKDC) form, Tenger Activity scale and Lysholm knee score. The study group consisted of 15 patients who met the inclusion criteria, of which 9 were male and 6 were female. The range of patient age consisted of 13-37 years and the average patient age was 20.6 years. The average male age was 22.11 years and the average female age was 18.33 years. The fracture classification showed 7 being type II while 8 were type III. Tegner Activity level at follow up ranged from 5-8 and the mean score was 6.4. On follow-up evaluation, the mean Lysholm score was 92.8 (ranging from 76-100). 6 patients who had inter-meniscal interposition was retracted or resected showed no difference in functional outcome. We found that displaced tibial eminence fractures could be successfully treated using arthroscopic pull through sutures, with most patients returning to their previous activity level. Complications were avoided by anatomic reduction of fracture fragments and early post-operative rehabilitation.
Aderinto J, Walmsley P, Keating JF. Fractures of the tibial spine: epidemiology and outcome. The Knee. 2008;15(3):164-7.
Tuca M, Bernal N, Luderowski E, Green DW. Tibial spine avulsion fractures: treatment update. Current opinion in pediatrics. 2019;31(1):103-11.
Strauss EJ, Kaplan DJ, Weinberg ME, Egol J, Jazrawi LM. Arthroscopic management of tibial spine avulsion fractures: principles and techniques. JAAOS-Journal of the American Academy of Orthopaedic Surgeons. 2018;26(10):360-7.
Gigante A, Setaro N, Rotini M, Finzi SS, Marinelli M. Intercondylar eminence fracture treated by resorbable magnesium screws osteosynthesis: a case series. Injury. 2018;49:S48-53.
Mclennan JG. The role of arthroscopic surgery in the treatment of fractures of the intercondylar eminence of the tibia. The Journal of bone and joint surgery. British volume. 1982;64(4):477-80.
Sawyer JR, Spence DD. Fractures And Dislocations in children.In :Frederick M.Azar,James,H.Beaty,S.Terry Canale (eds).Campbell’soperativeorthopaedics.13thed.Philadelphia: Elsevier . 1530-2.
Coyle C, Jagernauth S, Ramachandran M. Tibial eminence fractures in the paediatric population: a systematic review. Journal of children's orthopaedics. 2014;8(2):149-59.
Yuan Y, Huang X, Zhang Y, Wang Z. Treatment of tibial eminence fractures with arthroscopic suture fixation technique: a retrospective study. International journal of clinical and experimental medicine. 2015;8(8):13797.
Najdi H, Thévenin-Lemoine C, Accadbled F. Arthroscopic treatment of intercondylar eminence fractures with intraepiphyseal screws in children and adolescents. Orthopaedics & Traumatology: Surgery & Research. 2016;102(4):447-51.
Watts CD, Larson AN, Milbrandt TA. Open versus arthroscopic reduction for tibial eminence fracture fixation in children. Journal of Pediatric Orthopaedics. 2016;36(5):437-9.
Faunø P, Rømer L, Nielsen T, Lind M. The risk of transphyseal drilling in skeletally immature patients with anterior cruciate ligament injury. Orthopaedic journal of sports medicine. 2016;4(9).