Arthroscopic reattachment of tibial avulsion fractures of the posterior cruciate ligament using ABS button and tightrope (Mohandas Jagsun technique)
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20185341Keywords:
Posterior cruciate ligament avulsion, Knee arthroscopy, Fixation, ABS button (Arthrex), TightropeAbstract
Background: Avulsion fractures of tibial insertion of the posterior cruciate ligament are rare among the knee injuries. Purpose of this study is to determine the functional outcome of arthroscopic reattachment of tibial avulsion of the Posterior cruciate ligament by ABS button (Arthrex) and tight rope.
Methods: 15 Patients with PCL avulsion fracture were included. The Inclusion criteria were: 1) Displaced avulsion fractures (type-2 and type-3). They were followed at regular intervals using IKDC score, Lysholm score and subjective questionnaire.
Results: All cases showed complete osseous union during follow up. All knees are stable on examination by posterior sag sign and posterior drawer test. Two patients had loss of about 100 flexion. According to the IKDC form assessment 13 patients classified as normal and 2 were classified as near normal.
Conclusions: Arthroscopic reattachment of tibial avulsion fractures of the posterior cruciate ligament using ABS button and tightrope gives fairly good clinical outcomes.
References
Huang W, Gong X, Rahul M, Priyanka S, Wang C, Liang X, Ding G, Hu NN. Anterior arthroscopic assisted fixation of posterior cruciate ligament avulsion fractures. 2015;20:88.
Taghi Nourbakhsh ST, Bahramian F, Zafarani Z, Alidousti A, Aslani H, et al. Arthroscopic Bridge Technique for PCL Avulsion: Surgical Technique and Key Points. Archives Bone Joint Surg. 2016;4
Sedeek SM, Choudry Q, Karunatilake NAA, Arshad MS. Posterior cruciate ligament injury: Diagnosis and management. Hard Tissue. 2014;3(2):11.
Gali JC, de Sousa Oliveira HC, Lisboa BCB, Dias BD, de Godoy Casimiro F, Caetano EB. Tibial Insertions of the Posterior Cruciate Ligament: Topographic Anatomy and Morphometric Study. Rev Bras Ortop. 2013;48(3):263-7.
White EA, Patel DB, Matcuk GR, Forrester DM, Lundqis RB, George FR. Cruciate ligament avulsion fractures: Anatomy, biomechanics, injury patterns, and approach to management. Emergency Radiol. 2013;20(5):429–40.
Sasaki SU, da Mota e Albuquerque RF, Amatuzzi MM, Pereira CA. Open screw fixation versus arthroscopic suture fixation of tibial posterior cruciate ligament avulsion injuries: a mechanical comparison. Arthroscopy. 2007;23(11):1226–30.
Lee KW, Yang DS, Lee GS, Choy WS. Suture Bridge Fixation Technique for Posterior Cruciate Ligament Avulsion Fracture. Clinics in Orthopedic Surg. 2015;7:505-8.
Joshi S, Bhatia C, Gondane A, Rai A, Singh S, Gupta S.Open Reduction and Internal Fixation of Isolated Posterior Cruciate Ligament Avulsion Fractures: Clinical and Functional Outcome. Knee Surg Relat Res. 2017;29(3):210-6.
Gwinner C, Kopf S, Hoburg A, Haas NP, Jung TM. Arthroscopic Treatment of Acute Tibial Avulsion Fracture of the Posterior Cruciate Ligament Using the TightRope Fixation Device. Arthroscopy Techniques. 2014;3(3):377-82.
Rosenthal MD, Rainey CE, Tognoni A, Worms R. Evaluation and management of posterior cruciate ligament injuries. Phys Ther Sport. 2012;13:196-208.
Yang CK, Wu CD, Chih CJ, Wei KY, Su CC, Tsuang YH. Surgical treatment of avulsion fractures of the posterior cruciate ligament and postoperative management. J Trauma. 2003;54(3):516–9.
Trickey EL. Injuries to the posterior cruciate ligament- Diagnosis and treatment of early injuries and reconstructions of late instability. Clin Ortho. 1980;147:76-81.
Meyers MH. Isolated avulsion of the tibial attachment of the Posterior cruciate ligament of the knee. J Bone Joint Surg Am. 1975;57:669-72.
Trickey EL. Rupture of the posterior cruciate ligament of the knee. J Bone Joint Surg. 1968;50(2):334–41.
Jazayeri SM, Esmaili Jah AA, Karami M. A safe posteromedial approach to the posterior cruciate ligament avulsion fracture. Knee Surg Sports Traumatol Arthrosc. 2009;17(3):244–7.
Martinez-Moreno JL, Blanco-Blanco E. Avulsion fractures of the posterior cruciate ligament of the knee-An experimental percutaneous rigid fixation technique under arthroscopic control. Clin Orthop Relat Res.1988;237:204–8.
Kim SJ, Shin SJ, Choi NH, Cho SK. Arthroscopically assisted treatment of avulsion fractures of the posterior cruciate ligament from the tibia. J Bone Joint Surg Am. 2001;83(5):698–708.9.
