Clinical Study Of Treatment On Avulsion Fracture Of Anterior Cruciate Ligament At Tibial Attachment With Composite Double Pulley Technique Under Knee Arthroscopy

Anterior cruciate ligament tibial arrest avulsion fracture is a common type of knee injury in clinic,and it is a reliable way to treat this type of fracture.However,there are many surgical methods for avulsion fracture of anterior cruciate ligament and no consensus has been reached.Objective:To investigate the clinical efficacy of suture anchor combined with double pulley technique under knee arthroscopy in the treatment of tibial eminence avulsion fracture of anterior cruciate ligament.Methods:31 patients with avulsion fracture at tibial insertion of anterior cruciate ligament treated from January 2020 to September 2021 were retrospectively analyzed,all patients were treated with composite double pulley technique under knee arthroscopy.Combined with X-ray,CT and MRI of knee joint before and after operation,the subjective function was evaluated by the International Knee literature Committee(IKDC)and Lysholm knee function score,KT-2000 and joint range of motion were used,and paired t test was used to evaluate the stability of knee joint before and after treatment.Results:(1)The average operation time of all patients in was(61 ± 5)min,the average follow-up time was(12.5 ± 1.2)months.All fractures healed without fracture displacement after six months,and there were no complications of popliteal fossa neurovascular injury,bone nonunion and knee joint adhesion,all patients had no limitation of knee flexion and extension,and only 5 patients had weak positive Lachman test I °.(2)The Lysholm score increased from(46.2 ± 7.9)to(87.2 ± 6.0)at the last follow-up,the IKDC score increased from(53.8 ± 5.2)to(83.1 ± 5.3)at the last follow-up,and the joint mobility increased from(46.2 ± 7.9)° to(127.2 ± 5.9)° at the last follow-up,the differences showed statistical significance between preoperation and postoperation(P<0.05).(3)The results of KT-2000 before and after operation: it was(11.5 ± 2.8)mm before operation at the knee flexion of 90 ° and the difference of anterior relaxation of knee joint was(4.2 ± 1.0)mm at 90 ° flexion in the last follow-up.The difference between preoperation and postoperation was statistically significant(P < 0.05).KT-2000 results showed that the stability of knee joint after operation was significantly improved compared with that before operation.Conclusion:Arthroscopic combined double pulley technique is effective in the treatment of ACL tibial arrest avulsion fracture.Studies have proved that this operation is safe and effective.After operation,stable fracture fixation effect can be obtained,which is conducive to early functional exercise of knee joint.The clinical subjective and objective functional scores and imaging indexes were satisfactory in the short and medium term postoperative follow-up.Especially suitable for adolescent patients,in the case of no damage to the epiphysis,to avoid the risk of a second operation,is worth promoting.