Arthroscopic Fixation of Posterior Cruciate Ligament Tibial Avulsion Fractures With Single-Suture and Dual EndoButtons via the Lateral Aspect of the Anterior Cruciate Ligament.

Abstract

Arthroscopic techniques have gradually replaced open surgery as a routine method for treating posterior cruciate ligament tibial avulsion fractures. However, traditional arthroscopic surgery is associated with problems such as limited visualization, unstable fixation, and unsatisfactory reduction. By comparing various methods reported in the literature and integrating clinical experience, our team has developed an optimized technique to address current surgical challenges. Using dual posteromedial portals, we adopt a "single-suture" method, in which the same epidural needle and a single suture are employed to encircle the posterior cruciate ligament via the lateral aspect of the anterior cruciate ligament, with dual EndoButtons applied for fixation. This technique not only precisely avoids the meniscofemoral ligaments and anterior cruciate ligament but also eliminates the need for separating the anterior cruciate ligament and posterior cruciate ligament, thus simplifying the procedure and reducing surgical injuries in the whole fixation process. It enhances fixation stability and surgical efficiency and preserves the posterior septum to promote postoperative functional recovery.