Systematic Comparison Of Incision And Arthroscopic Surgery For Posterior Cruciate Ligament Tibial Avulsion Fractures

Objective:By comparing the clinical results of incisional screw fixation and arthroscopic "herringbone" suture fixation in the treatment of posterior cruciate ligament tibial stop avulsion fractures,the advantages and disadvantages of these two surgical approaches were analyzed to provide a theoretical basis for the clinical decision on the surgical approach.Methods:The data of 64 patients with acutely displaced posterior cruciate ligament tibial stop avulsion fractures admitted to our hospital between January 2013 and December2021 were analyzed and divided into two groups according to the different surgical methods at different times: the arthroscopic group of 22 cases,15 males and 7 females,with an average age of(37.86±11.83)years,in which the total arthroscopic In the arthroscopic group,22 cases,15 males and 7 females,with an average age of(37.86±11.83)years,were operated with a total arthroscopic "human" suture internal fixation technique;in the incision group,42 cases,29 males and 13 females,with an average age of(43.29±11.00)years,were operated with an "inverted L" incision for internal fixation of the bone block at the back of the knee.The operating time,postoperative hospital stay,postoperative complications(lower limb venous thrombosis,incisional infection,etc.),fracture healing,knee Lysholm score,posterior drawer test,knee flexion mobility and other indices at the last follow-up were observed and compared between the two groups.Results:A total of 64 patients in both groups received a mean follow-up of 12.3 months(7 to 19 months).The mean operative time(90.45±20.11)min and mean postoperative hospital stay(10.18±2.24)days in the arthroscopic group were statistically significant(P<0.05)compared with the mean operative time(62.62±15.82)min and mean postoperative hospital stay(12.48±2.80)days in the incisional group.All patients showed bony healing on imaging data at the final follow-up.The incidence of postoperative complications was 4.55%(1/22)and 11.9%(5/42)in the arthroscopic and incision groups,respectively,with mean Lysholm scores of(89.27±3.27)and(89.43±4.14)at the last follow-up,respectively,and negative posterior drawer test rates of 90.91%(20/21)and 85.71(36/42)%,respectively,with mean Knee mobility was(130.64±2.95)degrees and(129.10±4.24)degrees,respectively,and the differences between the above four groups of indicators were not statistically significant(P >0.05).Conclusion:Both internal fixation with an incision screw and arthroscopic fixation with a "herringbone" suture for posterior cruciate ligament tibial stop avulsion fractures can achieve satisfactory surgical results,but the postoperative hospital stay is shorter with arthroscopic surgery,while incision surgery is more advantageous in terms of operative time.