[Objective]To compare the clinical efficacy of arthroscopic knotless anchor versus cannulated screw for fixation of posteri-or cruciate ligament(PCL)tibial avulsion fractures.[Methods]A retrospective study was performed on 28 patients who received arthroscop-ic reduction and fixation of acute PCL tibial avulsion fractures in our hospital from October 2013 to October 2020.According to doctor-pa-tient communication,14 patients had fractures fixed with knotless anchors,while the other 14 patients were with cannulated screws.The perioperative,follow-up and imaging data were compared between the two groups.[Results]All patients were operated on smoothly without serious complications.There were no significant differences in operation time,incision length,blood loss,incision healing grade and hospi-tal stay between the two groups(P＞0.05).The anchor groups proved significantly superior to the screw group in terms of intraoperative fluo-roscopy[(0)times vs(2.1±0.4)times,P＜0.001]and postoperative analgesic use[(2.1±0.5)days vs(3.1±0.6)days,P＜0.001],despite of the fact that the former spent significantly higher medical cost than the latter[(29 677.3±2 406.3)yuan vs(18 605.2±953.7)yuan,P＜0.001].There was no significant difference between the two groups in the time to regain full-weight bearing activity(P＞0.05).Compared with those 3 months after surgery,the VAS,IKDC and Lysholm scores,as well as ROM significantly improved in both groups at the last follow-up(P＜0.05),which were not statistically significant between the two groups at any time points accordingly(P＞0.05).Regarding to imaging,there were no statistically significant differences in fracture reduction quality and fracture healing time between the two groups(P＞0.05).At the last follow-up,there was no significant imaging change of worsening knee degeneration in both groups.[Conclusion]Both knotless anchor and cannulated screw fixation do achieve good consequences for PCL tibial avulsion fractures.In contrast,the knotless anchor has higher postoperative comfort but higher treatment costs.
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