2021 ISAKOS Biennial Congress ePoster
Atraumatic Suture Loop Technique For Acl Avulsion Fracture Fixation. Results Of A Prospective Cohort Study
Suresh Perumal, MS(Orth), Chennai, Tamilnadu INDIA
Prakash Ayyadurai, MS, Chennai, Tamilnadu INDIA
Parthiban Jeganathan, MS, Chennai, tamilnadu INDIA
Karthik Anand Parachur, MS(Orthopaedics), Chennai, Tamilnadu INDIA
Arumugam Sivaraman, MS(Orth), AB(IM)(USA), FRCS(Glasg), Chennai, Tamilnadu INDIA
SRI RAMACHANDRA INSTITUTE OF HIGHER EDUCATION & RESEARCH, chennai, INDIA
FDA Status Not Applicable
Summary
Simple and reproducible fixation technique for ACL avulsion fractures
ePosters will be available shortly before Congress
Abstract
Background
Arthroscopic ACL avulsion fracture fixation is almost standard of care for displaced fractures in the recent past. Numerous techniques including arthroscopic cancellous screw fixation and various suture bridge technique have been practiced till date with good to excellent outcomes. We present our results in case series of unique arthroscopic technique employing atraumatic suture loops around ACL for safe and effective fracture reduction & fixation.
Materials & methods
This prospective study was done from January 2014 - January 2018 involving 31 patients who underwent arthroscopic fixation for ACL avulsion fracture at our institution.
Isolated ACL avulsion fracture regardless of fracture pattern, single large fragment & comminuted fragments were included. Patient with concurrent major ligament & cartilage injuries were excluded. Atraumatic suture loops around ACL with #2fibre wire or fibre tape were used for fracture reduction & pull through via trans-tibial tunnels and fastened to a suture wheel on the anterior tibial cortex. These patients were followed up to period of 2-5 years and outcome evaluated following guidelines of radiological union, Lysholm knee score.
Results
The study population consisted of 13 females & 18 males with average age of 26.7 years. The fracture pattern dealt with were 7 cases type 2, 13 cases type 3 and 11 cases type 4 fractures using Modified Meyers & McKeevers classification. Fracture union was achieved in all cases within 3-4 months from surgical fixation. Lysholm score improved dramatically form average of 39.41±10.1 to 92.4±4.77 at the final followup (P<0.05). 1 of our patient developed inflammatory arthritis 1 year post surgery and had poor outcome in terms of pain & decreased range of movements, managed medically. Two patients developed arthro-fibrosis requiring arthroscopic arthrolysis. All the other patients returned to previous level of activities at final followup.
Conclusion
Atraumatic arthroscopic suture loop technique for ACL avulsion fracture fixation is a simple, reproducible and effective surgical technique. This versatile technique can be employed in all types of ACL avulsion fractures and achieves satisfactory clinical outcomes in terms of fracture union & return to previous level of activities.