Arthroscopic treatment of displaced tibial eminence fractures using wire loop technique

Authors

  • Rajat Nirkhe Department of Orthopedics, Ruby Hall Clinic, Pune, Maharashtra
  • Hardik Sheth Department of Orthopedics, Ruby Hall Clinic, Pune, Maharashtra
  • Subodh Kumar Pathak Department of Orthopedics, Pramukhswami medical college, Karamsad, Gujarat
  • Raghav Barve Department of Orthopedics, Ruby Hall Clinic, Pune, Maharashtra
  • Sandeep Kumar Gour Department of Orthopedics, Chirayu Medical College, Bhopal, Madhya Pradesh
  • Prashanth Raj M. Department of Orthopedics, Sanjeevani Hospital, Kanhangad, Kerala

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20182735

Keywords:

Arthroscopy, Wire loop technique, Tibial spine avulsion, Anterior cruciate ligament, Knee joint

Abstract

Background: Several techniques of arthroscopic treatment of tibial spine avulsion fractures have been described in the literature. We conducted a study to analyze the results of arthroscopic assisted wire loop technique for treatment of tibial spine avulsion in adults and pediatric patients.

Methods: From June 2011 to December 2016, 52 patients with tibial spine fractures were surgically treated with arthroscopic reduction and wire loop fixation. Forty-four patients were adults and eight were in their pediatric age group. The age group ranged from 9 years to 52 years with the mean age of 26.2 years. 28 patients were type 2 and 24 were of type 3 fracture as classified by Myeres and Mckeever’s classification. The final analysis was done using clinical tests, radiological evaluation and International Knee Documentation Committee (IKDC) and Lysholm score.

Results: At final follow-up, the mean IKDC and Lysholm knee scores were, 92 and 93 respectively. All patients had a complete functional recovery and were able to return to work and to resume their activities.

Conclusions: Arthroscopic wire loop fixation is an excellent method for tibial eminence fracture in adults and children which gives excellent results in form of control tension on ACL on each side of avulsed fragment and also gives adequate mechanical strength for early rehabilitation.

References

Gronkvist, H. Fracture of the anterior tibial spine in children. J Pediatr Orthop. 1984;4:465-8.

Wiley JJ, Baxter MP. Tibial spine fractures in children. Clinorthop Rel Res. 1990;255:54-60.

Kendall N, Hsy S, Chan K. Fracture of the tibial spine in adults and children. Areview of 31 cases. J Bone Joint Surg Br. 1992;74(6):848-52.

Griffith J, Antonio GE, Tong CW, Ming CK. Cruciate ligament avulsion fractures. Arthroscopy. 2004;20(8):803–12.

Osti L, Buda M, Soldati F, Buono AD, Osti R, Maffulli N. Arthroscopic treatment of tibial eminence fracture: A systematic review of different fixation methods. Br Med Bull. 2016;118(1):73-90.

Lubowitz JH, Elson WS, Guttmann D. Part II: arthroscopic treatment of tibial plateau fractures: intercondylar eminence avulsion fractures. Arthroscopy. 2005;21:86–92.

Kocher MS, Micheli LJ, Gerbino P, Hresko MT. Tibial eminence fractures in children:prevalence of meniscal entrapment. Am J Sports Med. 2003;31:404–7.

Monto RR, Cameron-Donaldson ML, Close MA, Ho CP, Hawkins RJ. Magnetic resonance imaging in the evaluation of tibial eminence fractures in adults. J Knee Surg. 2006;19:187–90.

Meyers MH, McKeever FM. Fractures of the intercondylar eminence of the tibia. J Bone Joint Surg. 1970;52:1677-84.

Zaricznyj B. Avulsion fractures of the tibial eminence: Treatment by open reduction and pinning. J Bone Joint Surg. 1977;59:1111-4.

Hunter R, Willis J. Arthroscopic fixation of avulsion fractures of the tibial eminence: Technique and outcome. Arthroscopy. 2004;20(2):113–21.

Willis RB, Blokker C, Stoll TM, Paterson DC, Galpin RD. Long-term follow-up of anterior tibial eminence fractures. J Pediatr Orthop. 1993;13:361-4.

Kocher MS, Foreman ES, Micheli LJ. Laxity and functional outcome after arthroscopic reduction and internal fixation of displaced tibial spine fractures in children. Arthroscopy. 2003;19:1085-90.

Owens BD, Crane GK, Plante T, Busconi BD. Treatment of Type III tibial intercondylar eminence fractures in skeletally immature athletes. Am J Orthop (Belle Mead NJ). 2003;32:103-5.

Lysholm J, Gillquist J. Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med. 1982;10:150–4.

Sawyer GA, Anderson BC, Paller D, Schiller J, Eberson CP, Hulstyn M. Biomechanical analysis of suture bridge fixation for tibial eminence fractures. Arthroscopy. 2012;28:1533–9.

Lbbowitz JH, Grauer JD. Arthroscopic treatment of anterior cruciate ligament avulsion. Clin Orthop Relat Res. 1993;294:242–6.

Huang TW, Hsu KY, Cheng CY, Chen LH, Wang CJ, Chan YS, et al. Arthroscopis suture fixation of tibial eminence avulsion fractures. Arthroscopy. 2008;24(11):1232-8.

Lowe J, Chaimsky G, Freedman A, Zion I, Howard C. The anatomy of tibial eminence fractures: Arthroscopic observations following failed closed reduction. J Bone Joint Surg Am. 2002;84:1933-8.

Bong MR, Romero A, Kubiak E, Iesaka K, Heywood CS, Kummer F, et al. Suture versus screw fixation of displaced tibial eminence fractures: A biomechanical comparison. Arthroscopy. 2005;21:1172-6.

Eggers AK, Becker C, Weimann A, Herbort M, Zantop T, Raschke MJ, et al. Biomechanical evaluation of different fixation methods for tibial eminence fractures. Am J Sports Med. 2007;35:404–10.

Seon JK, Park SJ, Lee KB, Gadikota HR, Kozanek M, Oh LS, et al. A clinical comparison of screw and suture fixation of anterior cruciate ligament tibial avulsion fractures. Am J Sports Med. 2009;37:2334-9.

Downloads

Published

2018-06-23

Issue

Section

Original Research Articles