ArticleJournal of orthopaedic case reports2026
Arthroscopic Posterior Cruciate Ligament Tibial Spine Avulsion Fixation Using a Suture Pull-Through Single-Tunnel Technique.
Article in Journal of orthopaedic case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Posterior cruciate ligament (PCL) tibial avulsion fractures are uncommon intra-articular injuries that may cause persistent posterior instability, loss of motion, and functional impairment if displaced fractures are not anatomically reduced. Arthroscopic suture pull-through fixation offers stable transosseous fixation while avoiding complications associated with screw fixation. Aim: The aim of this study was to evaluate the functional and radiological outcomes of arthroscopic PCL tibial avulsion fixation using a suture pull-through single-tunnel technique. Materials and Methods: A prospective, single-center observational study without a control group was conducted in the Department of Orthopedics, N.D. Desai Medical College, from May 2026 to July 2026. Twenty-four patients with displaced isolated PCL tibial avulsion fractures underwent arthroscopic single-tunnel suture pull-through fixation. Lysholm scores and radiological union were assessed at 6 weeks, 3 months, and 6 months; no instrumented posterior laxity testing or additional validated patient-reported outcome measure was available. Results: The cohort included 24 patients with a mean age of 28 years (range 18-60 years). The mean Lysholm score improved from 41.6 ± 3.2 preoperatively to 81.2 ± 5.6 at 6 weeks, 90.7 ± 3.5 at 3 months, and 94.9 ± 2.3 at 6 months (Friedman P < 0.001). All fractures were recorded as united by 3 months on follow-up radiographs, and 22 patients (approximately 92%) reported return to their pre-injury activity level within 4-6 months. One patient developed a mild extension lag that improved with physiotherapy. No non-union, fixation failure, or revision surgery was observed during the 6-month follow-up; however, objective posterior translation was not measured. Conclusion: In this small single-center observational cohort, arthroscopic single-tunnel suture pull-through fixation was feasible and was associated with radiographic union and favorable short-term Lysholm score improvement. Because there was no comparator group, objective posterior stability testing, or long-term follow-up, these findings should not be interpreted as evidence of superiority or equivalence to other fixation techniques.
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