Clinical outcomes and complications of four surgical techniques for tibial avulsion fractures of the posterior cruciate ligament: a retrospective comparative study

Abstract Objective The optimal surgical approach for tibial avulsion fractures of the posterior cruciate ligament (PCL) remains controversial. This study aimed to compare the clinical outcomes of four techniques: arthroscopic suture fixation, arthroscopic loop plate fixation, open reduction with can...

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Main Authors: Zhenghui Hu, Yanze Xia, Chang She, Liubing Li, Wei Xu
Format: Article
Language:English
Published: BMC 2025-06-01
Series:Journal of Orthopaedic Surgery and Research
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Online Access:https://doi.org/10.1186/s13018-025-05953-3
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author Zhenghui Hu
Yanze Xia
Chang She
Liubing Li
Wei Xu
author_facet Zhenghui Hu
Yanze Xia
Chang She
Liubing Li
Wei Xu
author_sort Zhenghui Hu
collection DOAJ
description Abstract Objective The optimal surgical approach for tibial avulsion fractures of the posterior cruciate ligament (PCL) remains controversial. This study aimed to compare the clinical outcomes of four techniques: arthroscopic suture fixation, arthroscopic loop plate fixation, open reduction with cannulated screw fixation, and open reduction with anchor suture bridge fixation. Methods A retrospective review was conducted of 73 patients treated between January 2019 and December 2023 using one of four surgical techniques: arthroscopic suture fixation (Group A, n = 26), arthroscopic loop plate fixation (Group B, n = 14), open reduction with cannulated screw fixation (Group C, n = 16), and open reduction with anchor suture bridge fixation (Group D, n = 17). Demographic data, operative time, pre- and postoperative visual analog scale (VAS) pain scores, Lysholm scores, International Knee Documentation Committee (IKDC) scores, knee range of motion (ROM), and postoperative complications were analyzed. Results No significant differences were observed in baseline demographic data among the four groups (P >.05). Operative time was shortest in Group D (60.41 ± 12.39 min), significantly less than in the other groups (P =.0001). At 3 months postoperatively, all groups demonstrated significant improvements in VAS, Lysholm, and IKDC scores (P <.0001); however, intergroup differences were not statistically significant (P >.05). Group A demonstrated significantly less ROM recovery compared with the other groups (P =.0171). At final follow-up, further improvements in functional scores and ROM were observed in all groups, with no significant intergroup differences (P >.05). Complication rates differed significantly among the groups (P =.0361), with Group D reporting the lowest rate (0%) and Group A the highest (34.6%). Conclusion No significant differences were found in overall clinical outcomes among the four techniques. However, open reduction with anchor suture bridge fixation demonstrated favorable operative efficiency and complication profile, suggesting clinical advantages in selected patients. Trial registration Chinese Clinical Trial Registry: ChiCTR2500100641. Registration Date: 2025-04-11, Retrospectively registered.
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spelling doaj-art-e5dc3dba54254cc4b221ff21396a40482025-08-20T03:21:06ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-06-0120111310.1186/s13018-025-05953-3Clinical outcomes and complications of four surgical techniques for tibial avulsion fractures of the posterior cruciate ligament: a retrospective comparative studyZhenghui Hu0Yanze Xia1Chang She2Liubing Li3Wei Xu4Department of Orthopedics Surgery, The Second Affiliated Hospital of Soochow UniversityDepartment of Orthopedics Surgery, The Second Affiliated Hospital of Soochow UniversityDepartment of Orthopedics Surgery, The Second Affiliated Hospital of Soochow UniversityDepartment of Orthopedics Surgery, The Second Affiliated Hospital of Soochow UniversityDepartment of Orthopedics Surgery, The Second Affiliated Hospital of Soochow UniversityAbstract Objective The optimal surgical approach for tibial avulsion fractures of the posterior cruciate ligament (PCL) remains controversial. This study aimed to compare the clinical outcomes of four techniques: arthroscopic suture fixation, arthroscopic loop plate fixation, open reduction with cannulated screw fixation, and open reduction with anchor suture bridge fixation. Methods A retrospective review was conducted of 73 patients treated between January 2019 and December 2023 using one of four surgical techniques: arthroscopic suture fixation (Group A, n = 26), arthroscopic loop plate fixation (Group B, n = 14), open reduction with cannulated screw fixation (Group C, n = 16), and open reduction with anchor suture bridge fixation (Group D, n = 17). Demographic data, operative time, pre- and postoperative visual analog scale (VAS) pain scores, Lysholm scores, International Knee Documentation Committee (IKDC) scores, knee range of motion (ROM), and postoperative complications were analyzed. Results No significant differences were observed in baseline demographic data among the four groups (P >.05). Operative time was shortest in Group D (60.41 ± 12.39 min), significantly less than in the other groups (P =.0001). At 3 months postoperatively, all groups demonstrated significant improvements in VAS, Lysholm, and IKDC scores (P <.0001); however, intergroup differences were not statistically significant (P >.05). Group A demonstrated significantly less ROM recovery compared with the other groups (P =.0171). At final follow-up, further improvements in functional scores and ROM were observed in all groups, with no significant intergroup differences (P >.05). Complication rates differed significantly among the groups (P =.0361), with Group D reporting the lowest rate (0%) and Group A the highest (34.6%). Conclusion No significant differences were found in overall clinical outcomes among the four techniques. However, open reduction with anchor suture bridge fixation demonstrated favorable operative efficiency and complication profile, suggesting clinical advantages in selected patients. Trial registration Chinese Clinical Trial Registry: ChiCTR2500100641. Registration Date: 2025-04-11, Retrospectively registered.https://doi.org/10.1186/s13018-025-05953-3Posterior cruciate ligamentTibial avulsion fractureArthroscopySuture Bridge fixationRetrospective study
spellingShingle Zhenghui Hu
Yanze Xia
Chang She
Liubing Li
Wei Xu
Clinical outcomes and complications of four surgical techniques for tibial avulsion fractures of the posterior cruciate ligament: a retrospective comparative study
Journal of Orthopaedic Surgery and Research
Posterior cruciate ligament
Tibial avulsion fracture
Arthroscopy
Suture Bridge fixation
Retrospective study
title Clinical outcomes and complications of four surgical techniques for tibial avulsion fractures of the posterior cruciate ligament: a retrospective comparative study
title_full Clinical outcomes and complications of four surgical techniques for tibial avulsion fractures of the posterior cruciate ligament: a retrospective comparative study
title_fullStr Clinical outcomes and complications of four surgical techniques for tibial avulsion fractures of the posterior cruciate ligament: a retrospective comparative study
title_full_unstemmed Clinical outcomes and complications of four surgical techniques for tibial avulsion fractures of the posterior cruciate ligament: a retrospective comparative study
title_short Clinical outcomes and complications of four surgical techniques for tibial avulsion fractures of the posterior cruciate ligament: a retrospective comparative study
title_sort clinical outcomes and complications of four surgical techniques for tibial avulsion fractures of the posterior cruciate ligament a retrospective comparative study
topic Posterior cruciate ligament
Tibial avulsion fracture
Arthroscopy
Suture Bridge fixation
Retrospective study
url https://doi.org/10.1186/s13018-025-05953-3
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