Arthroscopic reduction and internal fixation (ARIF) versus open reduction internal fixation (ORIF) to elucidate the diff
- PDF / 824,249 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 99 Downloads / 208 Views
KNEE
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 trail (RCT) Silvampatti Ramaswamy Sundararajan1 · Joseph Babu Joseph1 · Rajagopalakrishnan Ramakanth1 · Amit Kumar Jha1 · Shanmuganathan Rajasekaran2 Received: 28 October 2019 / Accepted: 10 July 2020 © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2020
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. 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. 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 followup, 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. 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. Level of evidence II. Keywords Posterior cruciate ligament avulsion · Tibial-side PCL avulsion · ORIF · ARIF Abbreviations PCL Posterior cruciate ligament RCT Randomized-controlled trial CC Cannulated cancellous IKDC International Knee Documentation Committee mm Millimeter MRI Magnetic resonance imaging
Cm Centimeter Fig. Figure SPSS Statistical Packages for the Social Sciences USD United States Dollar ACL Anterior Cruciate Ligament PTD Posterior Tibiofemoral Displacement MIS Minimally Invasive Surgery
* Silvampatti Ramaswamy Sundararajan [email protected]
Introduction
1
Department of Arthroscopy and Sports Medicine, Ganga Medical Centre and Hospitals Pvt Ltd, 313 Mettupalayam Road, Coimbatore 641043, India
Department of Orthopaedics and Spine Surgery, Ganga Medical Centre and Hospitals Pvt Ltd, 313 Mett
Data Loading...
