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Arthroscopic reduction and internal fixation (ARIF) versus open reduction internal fixation (ORIF) to elucidate the difference for tibial side PCL avulsion fixation: a randomized controlled trial (RCT).
- Source :
-
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA [Knee Surg Sports Traumatol Arthrosc] 2021 Apr; Vol. 29 (4), pp. 1251-1257. Date of Electronic Publication: 2020 Jul 25. - Publication Year :
- 2021
-
Abstract
- Purpose: To compare the clinical, radiological outcomes, economic and technical differences for ORIF by cancellous screw fixation versus ARIF by double-tunnel suture fixation for displaced tibial-side PCL avulsion fractures.<br />Methods: Forty patients with displaced tibial-sided PCL avulsions were operated upon after randomizing them into two groups (20 patients each in the open and arthroscopic group) and followed up prospectively. Assessment included duration of surgery, cost involved, pre- and post-operative functional scores, radiological assessment of union, and posterior laxity using stress radiography and complications.<br />Results: The mean follow-up period was 33 months (27-42) (open group) and 30 months (26-44) (arthroscopic group). The duration of surgery was significantly larger in the arthroscopic group (47.8 ± 17.9 min) as compared to the open group (33.4 ± 10.1 min). The costs involved were significantly higher in the arthroscopic group (p- 0.01). At final follow-up, knee function in the form of IKDC (International Knee Documentation Committee) evaluation (89.9 ± 4.8-open and 89.3 ± 5.9-arthroscopic) and Lysholm scores (94.2 ± 4.1-open and 94.6 ± 4.1-arthroscopic) had improved significantly with the difference (n.s.) between the two groups. The mean posterior tibial displacement was 5.7 ± 1.8 mm in the open group and 6.3 ± 3.1 mm in the arthroscopic group which was (n.s.). There were two non-unions and one popliteal artery injury in the arthroscopic group.<br />Conclusion: Both ARIF and ORIF for PCL avulsion fractures yield good clinical and radiological outcomes. However, ORIF was better than ARIF in terms of cost, duration of surgery, and complications like non-union and iatrogenic vascular injury.<br />Level of Evidence: II.
- Subjects :
- Adolescent
Adult
Arthroscopy adverse effects
Bone Screws
Female
Follow-Up Studies
Fracture Fixation, Internal adverse effects
Fractures, Avulsion diagnostic imaging
Humans
Joint Instability etiology
Male
Middle Aged
Open Fracture Reduction adverse effects
Operative Time
Postoperative Complications
Prospective Studies
Radiography
Suture Techniques
Tibial Fractures diagnostic imaging
Treatment Outcome
Young Adult
Arthroscopy methods
Fracture Fixation, Internal methods
Fractures, Avulsion surgery
Open Fracture Reduction methods
Tibial Fractures surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1433-7347
- Volume :
- 29
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
- Publication Type :
- Academic Journal
- Accession number :
- 32712683
- Full Text :
- https://doi.org/10.1007/s00167-020-06144-9