Hu Zhenghui, Xia Yanze, She Chang, Li Liubing, Xu Wei
Department of Orthopedics Surgery, The Second Affiliated Hospital of Soochow University, Soochow, Jiangsu Province, 215005, China.
J Orthop Surg Res. 2025 Jun 9;20(1):578. doi: 10.1186/s13018-025-05953-3.
The optimal surgical approach for tibial avulsion fractures of the posterior cruciate ligament (PCL) remains controversial. This study aimed to compare the clinical outcomes of four techniques: arthroscopic suture fixation, arthroscopic loop plate fixation, open reduction with cannulated screw fixation, and open reduction with anchor suture bridge fixation.
A retrospective review was conducted of 73 patients treated between January 2019 and December 2023 using one of four surgical techniques: arthroscopic suture fixation (Group A, n = 26), arthroscopic loop plate fixation (Group B, n = 14), open reduction with cannulated screw fixation (Group C, n = 16), and open reduction with anchor suture bridge fixation (Group D, n = 17). Demographic data, operative time, pre- and postoperative visual analog scale (VAS) pain scores, Lysholm scores, International Knee Documentation Committee (IKDC) scores, knee range of motion (ROM), and postoperative complications were analyzed.
No significant differences were observed in baseline demographic data among the four groups (P >.05). Operative time was shortest in Group D (60.41 ± 12.39 min), significantly less than in the other groups (P =.0001). At 3 months postoperatively, all groups demonstrated significant improvements in VAS, Lysholm, and IKDC scores (P <.0001); however, intergroup differences were not statistically significant (P >.05). Group A demonstrated significantly less ROM recovery compared with the other groups (P =.0171). At final follow-up, further improvements in functional scores and ROM were observed in all groups, with no significant intergroup differences (P >.05). Complication rates differed significantly among the groups (P =.0361), with Group D reporting the lowest rate (0%) and Group A the highest (34.6%).
No significant differences were found in overall clinical outcomes among the four techniques. However, open reduction with anchor suture bridge fixation demonstrated favorable operative efficiency and complication profile, suggesting clinical advantages in selected patients.
Chinese Clinical Trial Registry: ChiCTR2500100641. Registration Date: 2025-04-11, Retrospectively registered.
后交叉韧带（PCL）胫骨撕脱骨折的最佳手术入路仍存在争议。本研究旨在比较四种技术的临床疗效：关节镜下缝线固定、关节镜下袢钢板固定、空心螺钉切开复位固定和锚钉缝线桥切开复位固定。
回顾性分析2019年1月至2023年12月期间采用四种手术技术之一治疗的73例患者：关节镜下缝线固定（A组，n = 26）、关节镜下袢钢板固定（B组，n = 14）、空心螺钉切开复位固定（C组，n = 16）和锚钉缝线桥切开复位固定（D组，n = 17）。分析人口统计学数据、手术时间、术前和术后视觉模拟量表（VAS）疼痛评分、Lysholm评分、国际膝关节文献委员会（IKDC）评分、膝关节活动范围（ROM）和术后并发症。
四组患者的基线人口统计学数据无显著差异（P >.05）。D组手术时间最短（60.41±12.39分钟），显著短于其他组（P =.0001）。术后3个月，所有组的VAS、Lysholm和IKDC评分均有显著改善（P <.0001）；然而，组间差异无统计学意义（P >.05）。与其他组相比，A组的ROM恢复明显较少（P =.0171）。在末次随访时，所有组的功能评分和ROM均有进一步改善，组间差异无统计学意义（P >.05）。各组并发症发生率差异有统计学意义（P =.0361），D组发生率最低（0%），A组最高（34.6%）。
四种技术的总体临床疗效无显著差异。然而，锚钉缝线桥切开复位固定显示出良好的手术效率和并发症情况，提示在特定患者中具有临床优势。
中国临床试验注册中心：ChiCTR2500100641。注册日期：2025年4月11日，回顾性注册。
