Comparison of Traditional Open Reduction and Internal Fixation and Arthroscopic Suture Fixation for Posterior Cruciate Ligament Tibial Avulsion Fracture

Objective Posterior cruciate ligament (PCL) avulsion fractures is a relatively rare disease that cause pain and disorder in knee. The purpose of this study was to compare the clinical outcomes of traditional open reduction and internal fixation (OPEN) and arthroscopic suture fixation (ASF) for treating PCL tibial avulsion fracture. Methods A retrospective analysis was carried out on 32 patients with PCL avulsion fracture from January 2020 to June 2023. All patients were evaluated by the pain visual analog scale (VAS) scores system after surgery. The patients were evaluated by the range of motion (ROM), lysholm and International Knee Documentation Committee (IKDC) system pre-operation and post-operation at the final follow-up time. Results Patients in both groups showed no difference in age, follow-up time, ROM, lysholm and IKDC scores before surgery. The operation time in OPEN group was 54.18 ± 7.26 minute, while the ASF group was 79.40 ± 5.90 minute with a statistics difference between these two groups. All patients achieved satisfactory scores of ROM, lysholm and IKDC post-operation. The VAS scores in OPEN group were 6.82 ± 0.51, 4.77 ± 0.62, 3.41 ± 0.48 and 1.80 ± 0.38 respectively at 1-day, 3-day, 1-week and 2-week post-operation, while the VAS scores in ASF group were 3.29 ± 0.46, 2.37 ± 0.38, 1.67 ± 0.29 and 0.97 ± 0.14 respectively. These two groups showed a significant difference in VAS scores at the time point of 1-day, 3-day, 1-week post-operation. Conclusion Both the two treatment methods achieved good clinical and radiological outcomes for PCL tibial avulsion fracture. The arthroscopic treatment technique requires more surgical time with the advantages of less pain reported in early postoperative period.