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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
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Author Spotlight: Double Posteromedial Approach for Treating Posterior Cruciate Ligament Cysts
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Open Approach for Repair of Tibial PCL Avulsion.

Nicholas Newcomb1, William Curtis1, Christopher Kurnik1

  • 1The University of New Mexico, Albuquerque, New Mexico, USA.

Video Journal of Sports Medicine
|May 1, 2025
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Summary

Open surgical fixation of tibial avulsion of the posterior cruciate ligament (PCL) offers successful outcomes. Early repair is crucial to prevent complications like arthrofibrosis, with open approaches showing lower rates.

Keywords:
PCL repairligament avulsionopen approachposterior cruciate ligamenttibial avulsion

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Traumatology

Background:

  • Tibial avulsion of the posterior cruciate ligament (PCL) often necessitates surgical intervention.
  • Acute identification and timely operative fixation are key to successful outcomes.
  • Both open and arthroscopic techniques are commonly employed for PCL avulsion repair.

Purpose of the Study:

  • To evaluate the efficacy and outcomes of open surgical fixation for tibial avulsion of the PCL.
  • To highlight the indications and surgical technique for open PCL avulsion repair.
  • To compare the incidence of arthrofibrosis between open and arthroscopic approaches.

Main Methods:

  • Open surgical fixation using a simplified approach with prone positioning.
  • Inverted L-shaped incision and development of a plane between gastrocnemius and semimembranosus muscles.
  • Reduction and fixation of the PCL tibial attachment with K-wires and screw fixation.

Main Results:

  • The patient achieved full range of motion and a stable posterior drawer test six months post-operation.
  • Successful return to work without difficulty was reported.
  • Studies indicate lower rates of arthrofibrosis with open PCL fixation compared to arthroscopic methods.

Conclusions:

  • Open surgical approach is a safe and effective treatment for PCL tibial avulsions.
  • Early repair of PCL avulsions is recommended, avoiding delays in intervention.
  • The open approach may be associated with a lower risk of arthrofibrosis compared to arthroscopic techniques.