Journal of Orthopaedic Surgery and Research (Jun 2024)

Modified arthroscopic repair of a posterior cruciate ligament tibial avulsion fracture improves IKDC and Lysholm score compared to open reduction

  • Xingxing Li,
  • Qiming Ma,
  • Quan Zheng,
  • Qiangbing Dou,
  • Liang Zhou,
  • Liangye Sun,
  • Song Shao,
  • Qiwei Wang

DOI
https://doi.org/10.1186/s13018-024-04851-4
Journal volume & issue
Vol. 19, no. 1
pp. 1 – 9

Abstract

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Abstract Purpose The purpose of this study was to analyse the difference between arthroscopic fixation and open reduction internal fixation (ORIF) of posterior cruciate ligament (PCL) tibial avulsion fractures. Methods This retrospective study analysed patients with an acute PCL tibial avulsion fracture who underwent surgical treatment at our hospital and follow-up for at least 24 months. Variables based on sex, age, Meyers–McKeever type, surgical method, meniscus tear, external fixation, labour or sports, Lysholm knee score, IKDC score, and KT-1000 value were also recorded. Multifactor unconditional logistic regression and Student’s t test with 1:1 propensity score matching (PSM) to remove confounding factors were used for analysis. Results Sixty-five cases achieved knee function graded as “good” or better, and 9 cases not. Single-factor analysis indicated that Meyers–McKeever type (χ 2 = 4.669, P = 0.031) and surgical approach (χ 2 = 9.428, P = 0.002) are related to functional outcomes. Multifactorial logistic regression analysis further confirmed that Meyers–McKeever typing (OR = 10.763, P = 0.036, [95% CI 1.174–98.693]) and surgical approach (OR = 9.274, P = 0.008, [95% CI 1.794–47.934]) are independent risk factors affecting prognosis. In addition, PSM verified significant differences in the Lysholm score (t = 3.195, P = 0.006), IKDC score (t = 4.703, P = 0.000) and A-KT/H-KT (t = 2.859, P = 0.012). However, the affected-side KT-1000 value (A-KT, mm, t = 1.225, P = 0.239) and healthy-side KT-1000 value (H-KT, mm, t = 1.436, P = 0.172) did not significantly differ between the two groups. The proportions of cases in which the Lysholm score, IKDC and A-KT/H-KT exceeded the minimal clinically important difference (MCID) were 62.5% (20/32), 62.5% (20/32) and 93.75% (30/32), respectively. Conclusion Compared with ORIF, an arthroscopic approach for PCL tibial avulsion fractures achieves better results. Level of evidence: Retrospective cohort study; Level II.

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