Clinical outcomes of all-endoscopic endobutton suspension fixation for posterior cruciate ligament tibial avulsion fractures
Objective To evaluate the clinical efficacy of all-arthroscopic endobutton suspension fixation in treating posterior cruciate ligament(PCL)tibial avulsion fractures.Method A retrospective analysis was conducted on 88 patients with PCL tibial avulsion fractures treated between January 2020 and March 2023.Two surgical methods were compared:46 patients in the observation group underwent all-arthroscopic endobutton suspension fixation,while 42 patients in the control group received traditional open reduction and internal fixation via a posteromedial inverted-L approach.The operative time,incision healing,hospital stay,fracture healing,and postoperative outcomes-including knee joint range of motion,IKDC score,Lysholm score,Tegner score,quadriceps strength symmetry index,single-leg vertical jump limb symmetry index(LSI),and ACL-RSI score were compared between the two groups.Results All patients were followed up for 12 to 16 months,with an average of 14 months.There were no peripheral neurovascular injury,nonunion,or internal fixation loosening in either group.However,two patients in the control group experienced incisional fat liquefaction.The observation group showed a shorter operative time(58.32±10.45)minutes and hospital stay(6.8±1.7)days compared to the control group(65.17±11.28)minutes and(10.2±2.3)daysrespectively,with statistically significant differences in both operative time(t=-2.957,P=0.004)and hospital stay(t=-7.825,P＜0.001).Repeated measures ANOVA showed significant interaction effects between group and time for knee range of motion(F_interaction=55.284,P＜0.001),IKDC score(F_interaction=7.915,P＜0.001),Lysholm score(F_interaction=5.192,P=0.001),and LSI index(F_interaction=9.374,P＜0.001),indicating different postoperative trends in knee function depending on the sur-gical technique.The main effect of time was significant for the Tegner score,quadriceps strength symmetry index,and ACL-RSI score,with postoperative scores significantly higher than preoperative ones(P＜0.05).Intergroup analysis showed significant dif-ferences in these scores between the two surgical methods(P＜0.05),suggesting variations in their effectiveness.Conclusion All-arthroscopic endobutton suspension fixation for PCL tibial avulsion fractures is a safe,minimally invasive,and reliable treat-ment option.This method provides offers satisfactory early functional recovery,with faster improvements in quadriceps strength symmetry and limb symmetry in single-leg vertical jump height,with a higher rate of return to sports and a shorter return-to-sport time than traditional surgery,making this method worthy of wider clinical application.
Tibial avulsion fractures of the posterior cruciate ligamentArthroscopyOpen reductionEndobutton
万方数据
维普
