Manaf Fadlurrahman, Widhiyanto Lukas, Hernugrahanto Kukuh Dwiputra
Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Airlangga, Mayjend. Prof. Dr. Moestopo No 6-8, Surabaya, 60286, East Java, Indonesia.
Department of Orthopaedics and Traumatology, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
Knee Surg Relat Res. 2025 Jul 24;37(1):31. doi: 10.1186/s43019-025-00282-5.
Tibial eminence fractures are common injuries that can cause significant functional limitations and require timely and effective treatment. Arthroscopic screw fixation and suture fixation are the primary methods used for managing displaced fractures. This study aimed to compare the functional and clinical outcomes between the two groups.
An associated systematic review was carried out with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines utilizing the PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Sage Journals, Science Direct, and Core Journals databases. Any language publication that assessed the results following the fixation of tibial eminence fractures by screw and suture fixation from 2000 to 2024 was included. Clinical, functional outcomes, subsequent surgeries, complications, operation time, and union time were evaluated. All data were assessed using SPSS version 25 and RevMan version 5.4.
A total of 9 studies involving 412 patients were analyzed out of 3365 papers. There were no significant differences (p > 0.05) between the two methods in the Lysholm score, Tegner Activity Scale, International Knee Documentation Committee (IKDC) score, range of motion, Lachman test, pivot-shift test, KT-1000, and union time. However, screw fixation had a significantly higher rate of subsequent surgeries (planned removal implant excluded) (29.75% versus 11.6%; p < 0.00001), complications (p = 0.0003), and shorter operation times (67 min versus 85 min; p = 0.0003).
The findings revealed that suture fixation carried a significantly lower risk of subsequent surgery and complications but required a longer operation time. Each technique presents advantages and challenges, making the decision a crucial aspect of patient care.
胫骨髁间隆起骨折是常见损伤，可导致明显的功能受限，需要及时有效的治疗。关节镜下螺钉固定和缝线固定是治疗移位骨折的主要方法。本研究旨在比较两组的功能和临床结果。
按照系统评价和Meta分析的首选报告项目（PRISMA）指南，利用PubMed、Cochrane对照试验中心注册库（CENTRAL）、Sage期刊、Science Direct和核心期刊数据库进行相关系统评价。纳入2000年至2024年期间任何评估螺钉和缝线固定胫骨髁间隆起骨折后结果的语言发表文献。评估临床、功能结果、后续手术、并发症、手术时间和愈合时间。所有数据使用SPSS 25版和RevMan 5.4版进行评估。
在3365篇论文中，共分析了9项研究，涉及412例患者。两种方法在Lysholm评分、Tegner活动量表、国际膝关节文献委员会（IKDC）评分、活动范围、Lachman试验、轴移试验、KT-1000和愈合时间方面无显著差异（p>0.05）。然而，螺钉固定的后续手术率（不包括计划取出植入物）显著更高（29.75%对11.6%；p<0.00001），并发症更多（p=0.0003），手术时间更短（67分钟对85分钟；p=0.0003）。
研究结果显示，缝线固定的后续手术和并发症风险显著更低，但手术时间更长。每种技术都有其优点和挑战，因此做出决策是患者护理的关键环节。
