Evaluation of the Suture Pull-Out Technique in Anterior Cruciate Ligament Avulsion Fractures at Different Weeks Post-fracture.

Background Anterior cruciate ligament (ACL) avulsion fractures often necessitate surgical intervention, with various fixation techniques available. Among these, the arthroscopic suture pull-out technique has gained attention as a promising approach. However, the influence of surgical timing on patient outcomes remains insufficiently studied. This study aims to evaluate the efficacy of the arthroscopic suture pull-out technique for ACL tibial avulsion fractures and assess how the timing of surgical intervention affects functional outcomes. Methodology This study was conducted at our hospital from November 2020 to October 2022. A total of 17 patients aged 21 to 41 years with isolated ACL avulsion fractures and no additional injuries or osteoarthritis were included. Participants were divided into three groups based on the interval from injury to surgery (one, two, or three weeks). The surgical procedure involved the suture pull-out technique. Postoperative management included immobilization, isometric exercises, and gradual weight-bearing. Functional outcomes were assessed using the Lysholm score, International Knee Documentation Committee (IKDC) score, Tegner Activity Scale, and Lachman test at 6, 10, and 14 months, along with radiological evaluations. Results Significant functional improvements were observed in all groups, with postoperative Lysholm, IKDC, and Tegner scores showing notable enhancements compared to preoperative values. No significant differences were found among the groups regarding the timing of surgery, indicating that delays within the first three weeks did not adversely impact outcomes. Most patients achieved a full range of motion. Two minor postoperative complications were reported, namely, one case of arthrofibrosis and one case of persistent laxity. Conclusions The arthroscopic suture pull-out technique is effective and reliable for ACL tibial avulsion fixation. The timing of surgery within the first three weeks does not significantly affect functional outcomes. Future research with larger sample sizes and longer follow-ups is recommended to further validate these findings and optimize surgical strategies.