Functional Outcomes Following Arthroscopic Suture Pull-Out Fixation for Displaced Tibial Spine Avulsion Fractures: A Single-Centre Prospective Study

Background: Tibial spine avulsion fractures, though uncommon, are functionally significant injuries that disrupt anterior cruciate ligament (ACL) continuity and knee joint stability. These fractures occur more frequently in adolescents and young adults and are often the result of high-energy trauma or sports-related injuries. Arthroscopic fixation techniques have emerged as the preferred modality due to their minimally invasive nature and ability to achieve stable reduction. Objective: To evaluate the functional outcome of patients undergoing arthroscopic suture pull-out fixation for displaced tibial spine avulsion fractures at a tertiary care center using standardized clinical scoring systems. Methods: This prospective study was conducted at All India Institute of Medical Sciences (AIIMS), Patna, Bihar. Patients with displaced tibial spine avulsion fractures (Meyers and McKeever type II–IV) treated with arthroscopic suture pull-out fixation using non-absorbable sutures were included. Clinical and functional outcomes were assessed using the Lysholm Knee Score and IKDC (International Knee Documentation Committee) Score at regular follow-up intervals over a period of six months. Results: A total of 25 patients were enrolled. The majority were adolescents with a mean age of 16.4 years. All patients achieved satisfactory fracture union with restoration of knee stability. At the final follow-up, the mean Lysholm Score was 91.6, and the mean IKDC Score was 87.8. No case of fixation failure, infection, or arthrofibrosis was reported. Most patients resumed pre-injury activity levels within 3 to 4 months. Conclusion: Arthroscopic suture pull-out fixation is a safe, effective, and functionally rewarding technique for displaced tibial spine avulsion fractures. It facilitates early rehabilitation, excellent joint stability, and high patient satisfaction with minimal complications.