pcl avulsion fracture arthroscopic fixation

0000091230 00000 n This article presents a case of a 13-year … 318 Nakagawa et al. 11. 0000090962 00000 n Several techniques of arthroscopic treatment of tibial spine avulsion fractures have been described in the literature. We describe a new arthroscopic technique for suture fixation of a posterior cruciate ligament (PCL) avulsion fracture from the tibia. We used this technique in 3 consecutive patients. 0000002570 00000 n This technique is indicated when the size of the avulsed fragment is small and fixation with a screw or pins is inadequate. 0000172984 00000 n 0000197870 00000 n Arthroscopic Pullout Fixation for a Small and Comminuted Avulsion Fracture of the Posterior Cruciate Ligament from the Tibia. Arthroscopy. 0000054540 00000 n ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. Arthroscopic Reduction and Internal Fixation of Posterior Cruciate Ligament Avulsion Fracture Using an Adjustable-Length Loop Device. PDF | Avulsion fractures of the tibial insertion of the posterior cruciate ligament (PCL) have always been regarded as rare injuries. 25 retrospectively compared arthroscopic suture fixation and open screw fixation in patients with PCL avulsion fractures, laxity measurements favoured arthroscopic management while Lysholm, Tegner activity, IKDC scores and one-leg hop test were similar between the two groups at 1 year of follow up. Arthroscopic Pullout Fixation of PCL Avulsion Fracture posterior capsule. A displaced avulsion fracture at the tibial attachment of the posterior cruciate ligament is considered an indication for surgical reduction and internal fixation … Arthroscopic fixation of tibial bony avulsion of the posterior cruciate ligament. 0000004068 00000 n ��+P�s�f�u�ؠM��I�� wJ��z��|xӽ��d�׭G��Z�Ia��I�o�%&N��>��6�P��FH/��>��]GS��l@��]�U��a��I��u��Q�� -�Y��V��$�R��Ļw�7R,j�g�e��B�>�z�b ��*ʨK��ڤ^J��q�X{�+#�k��в2C��01|(=��X��ta@ Abstract & Commentary. 0000149046 00000 n The bone hole was made with a 2-mm K wire, allowing its use for small and shattered bone fragments. An arthroscopic fixation technique for avulsion fractures of the PCL with a small or comminuted fragment was found to require drilling a 2-mm hole in the tibia, 4 a surgical procedure that was convenient and less invasive than previous methods. Reduce the avulsed fragment and obtain provisional fixation with Kirschner wires. ��t��qE��N�p�L֎7��*��N%8� J�U��#��ą� 0000148797 00000 n The aim of the study was to evaluate the clinical and functional results in patients with PCL tibial avulsion fractures treated by CC (cannulated cancellous) screw fixation. endstream endobj 389 0 obj <>stream After arthroscopic exploration and reduction of the bony fragment, a single tibia tunnel was established; then, the titanium button was guided through the tunnel and flipped onto the bony fragment to stabilize the fracture. 0000043437 00000 n 0000023331 00000 n 0000003253 00000 n The mean age was 30.8 years. 0000279458 00000 n Methods. Several techniques of arthroscopic treatment of tibial spine avulsion fractures have been described in the literature. H�\�ۊ�@��}��L��M^�u�4ig�5��\��kf�>��6U�we��ջ�|��ӵ��8��~��yq��a��?w�H᷻��rN�?nw� ��b��x�O�R�ף],�M��ûx��ݿ��c��"��i>��a�z�x�io�~��ۜ�/��c��0ݵ��0��*�?k�j��z��?=�2��a 1997; 13(6):759-762. 0000279190 00000 n 0000219648 00000 n A double-strand Ethibond suture was inserted into the joint and wrapped around the PCL from anterior to … The authors report no conflicts of interest in the authorship and publication of this article. 0000091852 00000 n 0000043182 00000 n Confirm reduction under fluoroscopy with emphasis on sagittal plane alignment. Dhillon MS, Singh HP, Nagi ON. 0000004444 00000 n Most authors suggest that displaced PCL avulsion fractures should undergo operative fixation and current data suggests excellent outcomes when treating these patients with either open or arthroscopic fixation, with a low complication rate. We report a case of avulsion fracture of the tibial attachment of the PCL managed by arthroscopic reduction and fixation. 0000003842 00000 n Full ICMJE author disclosure forms are available for this article online, as supplementary material. Material and method: June 2009 to March 2015, 15 patients with PCL tibia insertion avulsion fracture underwent arthroscopic reduction and modified figure eight wire loop fixation. The primary means for surgically treating a PCL avulsion fracture are open reduction through the direct posterior or posteromedial approach 3 and arthroscopic reduction and internal fixation. 0000255176 00000 n v?k^��>�(�#�D�2�{�#��*��0�ae``��n��m쁢N�^2��~a��=x:�F�V��(A!��%��fΟ&@��A�H2�M�Jy%2-�Wh�b�.��2��k �� Y� Arthroscopic Bridge Technique for PCL Avulsion: Surgical Technique and Key Points Abstract This study describes all-arthroscopic fixation of the posterior cruciate ligament avulsion fracture using ‘suture bridge technique’. 0000198382 00000 n For instance, Huang et al. 0000001791 00000 n Avulsion fracture of the posterior cruciate ligament from its tibial insertion is a rare condition. 0000011464 00000 n ��#�]�y=zO-J3|�u\��}�[�ź�� rX;��oC+j��3��I7%��~. 0000278893 00000 n 0000239054 00000 n 0000220379 00000 n Keywords: delayed avulsion fracture; posterior cruciate ligament; suture fixation… <<19FCA432CD824B41A6FBFA9B5ADE339A>]/Prev 662434/XRefStm 2220>> �c^��A�t�kѶh��H��Y$�Z$U��hM8%�ޢh-�c3R��)LL�D21E�sf��u�T3�db$SQ�(��y�Hi4Ȕh�H1�H��LE1�H�I�LE�ݜ9��O)��B�� eQ�, j��vYB�)D}RCT$ D �B�m��F��:ۤ^�m��%~�\��]��w�g�ϕ�C�J=�t�gҹ;�N�E�P��>=A}��.�8��U�Ŝ��&�囒�G�[�� $�,�uM}-��D�쳆3nx]�.h�� })� �(j(��[�ra3� ��D|� ��i�wx߄��\��(��w�W� K%� © 2020 by the Arthroscopy Association of North America. PCL avulsion fractures, although rare, should undergo fixation when displacement is present. endstream endobj 449 0 obj <>/Filter/FlateDecode/Index[36 342]/Length 34/Size 378/Type/XRef/W[1 1 1]>>stream The problems with standard open surgical techniques are that they are relatively invasive despite the limited operative field and it is impossible to explore intra-articular lesions by the posterior approach. We use cookies to help provide and enhance our service and tailor content and ads. Residual knee laxity of posterior cruciate ligament (PCL) avulsion fractures is often attributed to fracture non-union.13 When a bone fragment is avulsed and displaced, nonoperative treatment is invalid, as reported by a non-union rate of 80%.13 Many authors advocate operative treatment of a PCL tibial avulsion fracture if the bone 0000239320 00000 n This technique involves fixation by … Abstract. A large bony fragment that extended into the posterior part of the lateral tibial plateau allowed for reduction and retrograde fixation … This study examined the clinical outcomes of a newly developed technique, arthroscopic suture bridge fixation with crossover ties of PCL tibial avulsion fracture using two tibial tunnels and a posterior trans-septal portal. 0000003522 00000 n 0000255788 00000 n 0000110260 00000 n arthroscopically assisted reduction and wire loop fixation of avulsion fractures of the PCL from the tibia. Early surgical treatment has been regarded as necessary, but the optimal surgical technique remains unclear. 0000034922 00000 n 0000147507 00000 n https://doi.org/10.1016/j.eats.2020.08.028. endstream endobj 379 0 obj <>/Metadata 34 0 R/PageLabels 31 0 R/Pages 33 0 R/StructTreeRoot 36 0 R/Type/Catalog/ViewerPreferences<>>> endobj 380 0 obj <>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/StructParents 0/TrimBox[0.0 0.0 595.276 841.89]/Type/Page>> endobj 381 0 obj <> endobj 382 0 obj <> endobj 383 0 obj <> endobj 384 0 obj <> endobj 385 0 obj <> endobj 386 0 obj <>stream Abstract & Commentary. A trans-septal portal is created to visualize the fracture fragment directly, and the fragment is reduced and penetrated with a cannulated drill under fluoroscopic guidance. 0000042991 00000 n We present an arthroscopic reduction–internal fixation technique using an adjustable-length loop device. Published by Elsevier. Arthroscopic fixation using a suspensory fixation device was found to require only anteromedial, anterolateral, and posteromedial portals, without the need for a posterolateral portal. Conclusion: Arthroscopic suture fixation with autograft augmentation reconstruction for delayed tibial avulsion fractures of the PCL showed good clinical stability and function in this study. 0000002220 00000 n 0000148016 00000 n 0000172817 00000 n Prepare the osseous bed and remove hematoma and/or debris. Synopsis: A retrospective, nonrandomized study of arthroscopically assisted PCL-avulsion reattachments in 13 patients (14 knees) are described.Simultaneous posterolateral and posteromedial portals were used to insert ligament sutures (23 gauge wire or multiple sutures) or screw fixation. 0000034494 00000 n Vaselko M, Saciri V. Posterior approach for arthroscopic reduction and antegrade fixation of avulsion fracture of the posterior cruciate ligament from the tibia with cannulated screw and washer. All were satisfied and returned to the activities prior to injury. Synopsis: A retrospective, nonrandomized study of arthroscopically assisted PCL-avulsion reattachments in 13 patients (14 knees) are described.Simultaneous posterolateral and posteromedial portals were used to insert ligament sutures (23 gauge wire or multiple sutures) or screw fixation. Records were reviewed of 18 patients (median age 33.5 years, range 13–55 years) with PCL tibial avulsion fractures treated with an arthroscopic … 0000054610 00000 n h�b``� �X6�� cg`a��(��X��~��#��Lǳs�6�L"��Z�d��ynn��w��R � KKK� [�t� ��8?�Ү@��f`�a�d�Ĩ��tH�D�Db��D�zF�(�LF�J�%Ok%��53h3��0|d An arthroscopic procedure has the advantage of being minimally invasive and allowing the surgeon to detect and treat associated intra-articular injuries. A total of 30 acute (<3 weeks) isolated PCL tibial avulsion fractures were fixed under arthroscopy using the Endobutton device. Particular attention was paid to avoid injuring the PCL and bony fragment when shaving around the fragment. 378 73 The purpose of this technical note is to present a novel all-inside arthroscopic reconstruction technique for bony tibial avulsion fractures of the posterior cruciate ligament … 0000197897 00000 n Obtain definitive fixation with the method dictated by the fracture orientation. h�bb�f`b``Ń3� ��C;> d�� Few case reports demonstrate successful surgical treatment of the injury using screw fixation. A total of 22 patients with a tibial avulsion fracture involving the insertion of the posterior cruciate ligament (PCL) with grade II or III posterior laxity were reduced and fixed arthroscopically using routine anterior and double posteromedial portals. present a novel surgical approach for isolated PCL avulsion fractures consisting of an arthroscopic tech-nique using the TightRope device. H��W]o� }��b��0Ķ��CS��md�NQ��p��*uۼ�$ w�3�8�oO�}��7/�y��^n��G�q��[��O�ϞZ�}��^�)�~3��1�ˮ_��ވ��eV��gEd)��RJ ��/�K�"��U_*��b��o��g��Ȯ��[|]ȋ��W�$��2�W��{.e��,>��їf��}��ֶ7��x��u��M��^�nw��^5٫�vz��.&��t�E��y�u�շ*�[�~zw��1��v�� 0000050102 00000 n 0000005177 00000 n In spite of acute tibial avulsion fractures of the PCL being widely reported, 4,16 delayed avulsion fractures also occur because of a neglected diagnosis or the failure of nonoperative treatment. [7] T. Torisu, Isolated avulsion fracture of the tibial attachment of the posterior cruciate ligament, J … Figure 5(a-c): ACL and PCL avulsion fracture of the right knee in a 47 year old male fixed with screws for PCL and staples for ACL - "Displaced anterior cruciate ligament avulsion fractures: Arthroscopic staple fixation" 0000028259 00000 n In this study, we evaluate a new wiring technique for the treatment of these injuries. The medial wall of the posterior septum required partial shaving during the process, but entire perforation of the septum was not necessary. 0 0000172036 00000 n 0000042160 00000 n This study examined the clinical outcomes of a newly developed technique, arthroscopic suture bridge fixation with crossover ties of PCL tibial avulsion fracture using two tibial tunnels and a posterior trans-septal portal. 0000050798 00000 n tibial avulsion fracture of the posterior cruciate ligament with suture ﬁxation technique through Y-shaped bone tunnels, Arthroscopy, 22 (2006), 172–181. By tightening the loop, downward compression can be applied to the fragment. These techniques include the use of various fixation devices such as screws, K-wires, wiring, sutures, and suture anchors. 0000043845 00000 n 0000262134 00000 n Reproducing the anatomy of the native PCL enables the reconstructed ligament to restore physiological knee kinematics with well-documented radiographic healing. By Volker Musahl 10 Videos FEATURING Jonathan Watson. %%EOF PCL Avulsions: Arthroscopic Fixation. An adjustable-length loop device is relayed from the posteromedial portal and pulled out through the fragment in an anterograde fashion, placing a button on top of the fragment. 0000262731 00000 n After arthroscopic exploration and reduction of the bony fragment, a single tibia tunnel was established; then, the titanium button was guided through the tunnel and flipped onto the bony fragment to stabilize the fracture. The VDO demonstrate technique of the Arthroscopic fixation ACL avulsion fracture. Arthroscopic reduction and fixation of bony avulsion of the posterior cruciate ligament of the tibia. The mean age was 30.8 years. 0000035643 00000 n ... (3 cm or more in width) of an avulsion fracture of the posterior cruciate ligament with multiple cannulated screws have been described, those for a smaller fragment (1.5 cm or less in width) have not been well documented. endstream endobj 387 0 obj [411 0 R] endobj 388 0 obj <>stream 0000042292 00000 n We report a case of avulsion fracture of the tibial attachment of the PCL managed by arthroscopic reduction and fixation. 0000278618 00000 n A large bony fragment that extended into the posterior part of the lateral tibial plateau allowed for reduction and retrograde fixation … August 11, 2015. 0000003121 00000 n 2003; 19:916-21. trailer 0000016983 00000 n arthroscopic fixation with screws or sutures5-7. xref 0000124755 00000 n 1 The most popular technique used in arthroscopic surgery is fixation … Treatment of tibial PCL avulsion fractures by arthroscopic suture fixation is a successful technique to restore tibial avulsion injuries of the PCL … These techniques include the use of various fixation devices such as screws, K-wires, wiring, sutures, and suture anchors. 4, 9, 10 An arthroscopic fixation technique for avulsion fractures of the PCL with a small or comminuted fragment was found to require drilling a 2-mm hole in the tibia, 4 a surgical … A displaced avulsion fracture at the tibial attachment of the posterior cruciate ligament is considered an indication for surgical reduction and internal fixation because nonunion and remaining posterior instability of the knee are common consequences of conservative treatment. The purpose of this study was to objectively evaluate the functional results after open reduction and internal fixation of tibial PCL avulsion fractures with international knee documentation committee (IKDC) grades and stress radiography. 0000003956 00000 n 0000255439 00000 n This video showcases the open reduction and internal fixation of both an avulsed PCL (tibial ... read more ↘. found that the anterior arthroscopic-assisted fixation was a simple and feasible alternative for treating PCL avulsion fractures. Finally, an interference screw was squeezed into the tunnel to fix the end of the loop. H�\��j�0��~ �C��UZ��2�a,�$��8�!o?�.L`�'��-��^[�=�w��=��(��rsa�I�場�w/�r�-�$��ܚqau ��w��2��7��i3��w7kpF�A@Ӏ.z��k?#�(;��o��e|n!�~��]o&d� k�~&k�/��$F��;V�'J"?7��'⢈Lq��\%��"h�kd:X]%m��t�H/�Xڽ�P$��7��8��u�W|��],�*,�+� �ʄ� 0000148396 00000 n Sabat et al. This technique pro-vides accurate reconstruction of the anatomic footprint and rigid ﬁxation for early rehabilitation, and it can address concomitant intra-articular lesions. Open Posterior Approach for Internal Fixation of PCL Tibial Avulsion. We hypothesize that the patients will report In 6 patients a suture-bridge technique via a mini-open approach was performed due to … 0000042587 00000 n 450 0 obj <>stream Repairing a PCL avulsion can be either through the conventional open approach or through arthroscopic surgery. PCL Avulsions: Arthroscopic Fixation. In summary, the presented technique offers the opportunity to achieve arthroscopic, anatomic reconstruction of tibial bony avulsion fractures of the PCL. Overall, this technique provides good reduction and bone union, and excellent clinical outcomes, including posterior knee stability, can be achieved. Arthroscopy . Copyright © 2021 Elsevier B.V. or its licensors or contributors. 0000035332 00000 n Material and method: June 2009 to March 2015, 15 patients with PCL tibia insertion avulsion fracture underwent arthroscopic reduction and modified figure eight wire loop fixation. 0000262394 00000 n 0000004417 00000 n 0000172405 00000 n arthroscopically assisted reduction and wire loop fixation of avulsion fractures of the PCL from the tibia. 0000281284 00000 n In this study, we evaluate a new wiring technique for the treatment of these injuries. 1 The open technique is relatively invasive despite its limited operative field, whereas the arthroscopic procedure has the advantage of allowing the surgeon to detect and treat associated intra-articular lesions. 0000124489 00000 n �r�ϲ"[*�9��Ґ|RI�H�V�A:�Y4�i��4TA�HH+� �E�t�+"��-� *Z�Vq Trickey EL. 0000054739 00000 n 0000172887 00000 n By continuing you agree to the use of cookies. Presented at the 2018 European Society of Sports Traumatology, Knee Surgery & Arthroscopy meeting, May 9-12, 2018, Glasgow, United Kingdom. Records were reviewed of 18 patients (median age 33.5 years, range 13–55 years) with PCL tibial avulsion fractures treated with an arthroscopic … 0000002405 00000 n Arthroscopic surgery has the added advantage of being minimally invasive with fewer wound healing problems as compared with open surgery. Posterior cruciate ligament (PCL) avulsion-fracture arthroscopic reinsertion utilizing a posterior trans-septal arthroscopic approach. 378 0 obj <> endobj 0000197502 00000 n 0000219909 00000 n An avulsion fracture of the PCL, if not surgically fixed, may lead to secondary changes in the knee joint. INTRODUCTION: To describe the clinical outcomes of arthroscopic fixation of displaced posterior cruciate ligament (PCL) avulsion fractures with/without associated tibia plateau fractures using an adjustable loop suspensory fixation device. 0000239726 00000 n Arthroscopic fixation of posterior cruciate ligament avulsion fractures: A new minimally invasive technique. [All-arthroscopic Fixation of Tibial Posterior Cruciate Ligament Avulsion Fractures With a Suture-Button Technique] Since 2016 eight tibial PCL avulsions were treated. 0000197239 00000 n It does not startxref 0000000016 00000 n 0000149474 00000 n Rupture of the posterior cruciate ligament of the knee. [ Links ] 12. %PDF-1.4 %��

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