Arthroscopic Reduction and Internal Fixation of Tibial Eminence Fractures With Transosseous Suture Bridge Fixation

Arthroscopic reduction–internal fixation (ARIF) is an increasingly popular option for surgical management of displaced tibial eminence fractures. Although a variety of ARIF techniques have been described, anatomic reduction and stable fixation remain challenging. As a result, complications such as malunion, nonunion, anterior instability, arthrofibrosis, and hardware issues persist. In an effort to reduce complications and improve outcomes, modern suture-based ARIF techniques have been developed. However, the optimal technique and construct remain elusive. This article presents a technique for ARIF of tibial eminence fractures using a transosseous suture bridge construct with extracortical fixation. This technique uses a commercially available suture-passage device and meniscal root repair system for accurate tunnel placement, efficient suture management, and reliable fixation.