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[Effectiveness comparison of two arthroscopic different fixations for anterior cruciate ligament tibial eminence
Huanyi Li1, Haishan Wu, Yuli Wu
1Department of Orthopaedics, Shanghai Changzheng Hospital, Shanghai 200003, PR China.
Objective:
To compare the effectiveness of arthroscopic screw and suture fixations in treatment of anterior cruciate ligament tibial eminence avulsion fractures.
Methods:
Between January 2002 and January 2009, 43 patients with fresh anterior cruciate ligament tibial eminence avulsion fracture were treated, which were rated as types II and III according to Meyers-McKeever-Zaricznyj classification. Fractures were fixed with either screw (screw group, n = 21) or nonabsorbable suture (suture group, n = 22). There was no significant difference in sex, age, disease duration, and fracture type between 2 groups (P > 0.05). The range of motion (ROM) and Lysholm score were compared between 2 groups, and the knee stability was evaluated based on the Lachman test and KT-2000 measurement.
Results:
The operation time was 48-60 minutes (mean, 51.6 minutes) in the screw group, and 55-68 minutes (mean, 63.2 minutes) in the suture group, showing significant difference (t = 4.645, P = 0.032). Incisions healed by first intention and no complication occurred in 2 groups. All patients were followed up (5.7 +/- 0.6) years in the screw group and (5.3 +/- 0.5) years in the suture group. The fracture healed completely in both groups; the healing time was (3.3 +/- 0.6) months in the screw group and (3.2 +/- 0.4) months in the suture group, showing significant difference (t = 3.723, P = 0.019). Between the screw group and the suture group, no significant difference was found in ROM [(128.6 +/- 10.1)degrees vs. (130.2 +/- 14.1) degrees, P > 0.05] and Lysholm score (94.6 +/- 14.5 vs. 95.1 +/- 17.2, P > 0.05). The stabilities based on KT-2000 measurement were also similar between 2 groups at last follow-up [(0.9 +/- 0.3) mm vs. (1.0 +/- 0.4) mm, P > 0.05]. Lachman test of 2 groups were negative.
Conclusion:
Both the screw and nonabsorbable suture fixation techniques for anterior cruciate ligament tibial eminence avulsion fracture (type II or III) have good results in terms of functional outcome and stability. However, some patients show flexion contractures of 5 degrees or 10 degrees.