Comparative clinical efficacy of arthroscopic suture bridge combined with strengthening thread fixation technique and traditional open double-row anchor suture fixation technique for posterior cruciate ligament insertion fractures
10.3969/j.issn.1000-6710.2025.02.001
- VernacularTitle:关节镜下桥式缝合联合加强线复位固定技术和传统切开双排锚钉缝合固定后交叉韧带止点撕脱骨折的早期临床疗效比较
- Author:
Weitong LIU
1
;
Jingfan YANG
;
Jinlei LI
;
Tao WANG
;
Yanbo WANG
;
Yaoda ZHANG
;
Hongyun LI
Author Information
1. 昆明市中医医院骨科(云南 昆明 650011)
- Publication Type:Journal Article
- Keywords:
posterior cruciate ligament tibial insertion fracture;
arthroscopy;
strengthening thread;
minimally invasive surgery
- From:
Chinese Journal of Sports Medicine
2025;44(2):89-94
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the early clinical efficacy of arthroscopic bridge suture combined with strengthening thread fixation for posterior cruciate ligament(PCL)tibial insertion avulsion frac-tures and traditional open double-row anchor suture fixation,and to explore a safe,effective,and min-imally invasive reduction and fixation method for PCL tibial insertion fractures in knee joint under ar-throscopy.Methods This study was a retrospective study.Sixty patients with PCL tibial insertion frac-tures(Meyers&McKeever types II-IV)and admitted to the Department of Orthopedics of Kunming Hospital of Traditional Chinese Medicine between June 2021 and June 2023 were included,and ran-domly divided into a traditional group(age:39.56±3.24 years,male/female:16/14)and a minimally in-vasive group(age:40.32±4.38,male/female:18/12),each of 30,according to their admission or-der.All patients were of Grade III positive in the drawer test before surgery.The traditional group un-derwent posterior medial inlay incision,reduction under direct vision and double-row anchor suture fix-ation,while the minimally invasive group underwent reduction under total arthroscopy,suture-bridge suture at the tendon-bone junction of PCL,and one anchor suture placed at the femoral insertion of PCL,with the anchor suture line serving as the reinforcing suture.Then,the anchor and suture-bridge suture lines were respectively pulled into the two tunnels behind the tibia from the front and then pulled out from the front of the tibia,and the reinforcing suture was knotted in front of the tib-ia.The bridge suture line was fixed in front of the tibia with an external row anchor.Six months after surgery,both groups were evaluated the efficacy using the posterior drawer test and Lysholm score.Re-sults At the follow-up six months after the surgery,both groups had good fracture healing,with one wound infection and delayed healing in the traditional group and total one-stage heal in the other group.According to the physical examination 6 months after surgery,all were negative in the posterior drawer test,except one of degree II positive in the traditional group.Moreover,the average Lysholm score of the traditional group increased from 65.23±3.48 before surgery to 87.64±4.58 points after surgery(P<0.05),while that of the minimally invasive group increased from 64.35±2.52 to 86.82±2.58(P<0.05),showing no significant differences between the two groups(P>0.05).Conclusion Both techniques in this study can achieve excellent surgical outcomes in the treatment of posterior cruciate ligament avulsion fractures at the tibial insertion site.
