Results of Arthroscopically Assisted Refixation of Fractures of the Intercondylar Eminence

Aim: In order to restore ACL function and therefore knee joint stability, the surgical refixation of anterior cruciate ligament avulsion fractures is a consistent recommendation in literature. The objective of this study was to evaluate the clinical results after arthroscopic fixation of dislocated avulsion fracture of the intercondylar eminence depending on patient age and refixation technique. Method: 24 patients (50% below 16 years) with anterior cruciate ligament avulsion fractures were treated either with arthroscopic screw fixation (n = 17) or transtibial suture refixation (n = 7). Clinical follow-up examination was conducted on average 4.1 years after operation. Results: 17% of the patients presented with additional intra-articular lesions. Osseous integration of the avulsion fragment was documented on plain radiographs on average 6.1 weeks after surgery in adults and after 3.9 weeks in children. Free range of motion was accomplished after 11.3 weeks. The choice of surgical technique did not show any influence on healing period or rehabilitation. The complication rate was 16.6% in skeletally immature patients and 8.3% in adults. IKDC scores: A10, B2 in children; A9, B3 in adults. Tegner scores: children 5.8, adults 4.1. Lysholm scores: children 93, adults 88. Conclusions: Neither the patients' age nor the refixation technique selected yielded a significant correlation to the accomplished clinical score. Both arthroscopic screw fixation and transtibial suture fixation are appropriate surgical procedures regarding results and complication rate.