Arthroscopic Reduction and Internal Fixation of Tibial Eminence Fractures With Transosseous Suture Bridge Fixation

Arthroscopic reduction-internal fixation (ARIF) is an increasingly popular option for surgical management of displaced tibial eminence fractures. Although a variety of ARIF techniques have been described, anatomic reduction and stable fixation remain challenging. As a result, complications such as malunion, nonunion, anterior instability, arthrofibrosis, and hardware issues persist. In an effort to reduce complications and improve outcomes, modern suture-based ARIF techniques have been developed. However, the optimal technique and construct remain elusive. This article presents a technique for ARIF of tibial eminence fractures using a transosseous suture bridge construct with extracortical fixation. This technique uses a commercially available suture-passage device and meniscal root repair system for accurate tunnel placement, efficient suture management, and reliable fixation.