[ARTHROSCOPICALLY ASSISTED TREATMENT OF POSTERIOR CRUCIATE LIGAMENT AVULSION FRACTURE WITH MENISCUS POSTERIOR HORN TEAR].

OBJECTIVE

To evaluate the effectiveness of arthroscopically assisted treatment of posterior cruciate ligament (PCL) tibial eminence avulsion fractures associated with meniscus posterior horn tear.

METHODS

Between January 2012 and December 2014, 21 patients with PCL avulsion fracture and meniscus posterior horn tear were arthroscopically treated with polyester suture and hollow screw fixation. There were 10 males (10 knees) and 11 females (11 knees), aged 14-53 years (mean, 35.7 years). The causes included sport injury in 11 cases, traffic accident injury in 9 cases, and daily life injury in 1 case. Based on the anteroposterior and lateral X-ray films, CT, and MRI, PCL avulsion fractures were diagnosed, and 2 cases had anterior cruciate ligament avulsion fractures. The results of posterior drawer test were positive in all patients, with no end point in 14 cases and with soft end point in 7 cases; all patients showed tibial sink. The preoperative International Knee Documentation Committee (IKDC) score and Lysholm score were 46.5±5.5 and 43.3±4.5 respectively. The time from injury to operation was 6-22 days (mean, 10 days).

RESULTS

The operation time was 60-100 minutes (mean, 75 minutes). Primary healing of incision was obtained in all patients, without no complication of infection. The mean follow-up time was 27.4 months (range, 12-46 months). The results of posterior drawer test were negative in 19 cases, and positive in 2 cases (having hard end point). Tibial sink disappeared. At last follow-up, X-ray film showed good healing of fracture, and no displacement. The patients had no locking knee, snapping or tenderness of joint space, and the Mcmurray sign was negative; the IKDC score and Lysholm score were significantly improved to 92.0±2.5 and 92.7±2.6 respectively (=-39.903, =0.000; =-43.242, =0.000). The range of motion was normal in 20 patients (0-130°) except 1 patient having limited flexion (0-80°), whose range of motion returned to 0-120° after release.

CONCLUSIONS

The arthroscopic fixation technique has satisfactory results for the reduction and fixation of PCL avulsion fracture associated with meniscus posterior horn tear because of easy operation, firm fixation, and economic price.