To compare clinical outcomes of arthroscopic therapy for tibial eminence avulsion fracture with loop ligature suture and absorbable suture anchor.

From June 2012 to February 2018 62 patients with avulsion fractures of the anterior cruciate ligament injured within three weeks in First Medical Center of PLA General Hospital were selected in the study. All the affected knees have normal function before injury. The patients with open fracture, multiple fracture, tibial plateau fracture, meniscus and ligament injury were excluded in the study. All the patients were divided into two groups according to different operation methods: 30 patients were treated with arthroscopic reduction and fixation using loop ligature suture, as the suture group; 32 patients were treated with arthroscopic reduction and fixation using absorbable suture anchor, as the anchor group. The operation time and intraoperative blood loss of the two groups were compared. Knee joint stability of two groups was compared by front drawer test, Lachman test and axial shift test. Knee joint function of two groups was compared by Lysholm score and International Knee Documentation Committee (IKDC) 2000 subjective score. The independent sample t test was used to compare the quantitative data between two groups. The paired t test was used to compare the quantitative data within groups, and the chi-square test was used for compare the qualitative data between the two groups.

All the incisions healed primarily. Radiographic evaluation showed bone union within three months postoperatively in both groups. The mean follow-up period after the operation was (22±8)months in suture group and (19±7)months in anchor group. The operation time in anchor group was lower than that in suture group, and the difference was statistically significant (t=2.491, P<0.05). There was no significant difference of intraoperative blood loss between two groups (t=1.506, P>0.05). The Lysholm score were both improved in two groups after operation for six months. The difference was statistically significant(suture group: t=26.265, P<0.05; anchor group: t=29.857, P<0.05). The IKDC 2000 subjective scores were both improved in two groups after operation for six months.The difference was statistically significant(suture group: t=35.619, P<0.05; anchor group: t=37.004, P<0.05). There was no significant difference in anterior drawer test, Lachman test, pivot shift test, Lysholm score and IKDC 2000 subjective scores between two groups after operation for six months (P>0.05).

In the arthroscopic therapy for tibial eminence avulsion fracture, the loop ligature suture fixation and absorbable suture anchor fixation have their own characteristics but equivalent clinical effects, which could both provide satisfying reduction, rigid fixation, well healing of avulsed fragment and effective functional rehabilitation.