J Knee Surg 2021; 34(12): 1355-1358
DOI: 10.1055/s-0040-1709180
Original Article

Subintermeniscal Ligament Pullout Suture Technique for Anterior Cruciate Ligament Avulsion Fracture Fixation—AIIMS Technique

Ravi Mittal
1   Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), New Delhi, India
,
1   Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), New Delhi, India
,
Rajkumar Selvanayagam
1   Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), New Delhi, India
› Author Affiliations
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Abstract

Many methods have been described, including pullout suture technique, for arthroscopic fixation of displaced tibial eminence fracture. We are describing our technique of pullout suture, which is a modification of previously described techniques. We passed two sutures arthroscopically through anterior cruciate ligament (ACL) just above the avulsed fragment and then pulled them out through medial and lateral bone tunnel in anterior aspect of crater in tibial plateau. The third suture passed through ACL was pulled out anteriorly under the transverse intermeniscal ligament through a submeniscal route. All sutures were tied under tension to a screw post placed on the anterior tibia after reducing the avulsed bone fragment. Our technique provides good reduction and even overreduction of the fragment. It also provides good initial fixation strength to work against displacing forces even in small and comminuted bony fragment. This is helpful for achieving adequate stability of knee, complete extension of knee, early rehabilitation, and quicker recovery.



Publication History

Received: 14 March 2019

Accepted: 16 February 2020

Article published online:
24 April 2020

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