Good functional outcomes and radiological union following arthroscopic knotless anchor fixation of tibial spine avulsion fractures: A prospective clinical study

Purpose Tibial spine avulsion fractures compromise ACL function and are common in children and adolescents. Traditional fixation methods may risk physeal injury and intra‐articular damage. Arthroscopic suture‐based techniques offer a minimally invasive, physeal‐sparing alternative. Methods Twenty‐five patients (mean age: 19 years) with type II–IV tibial spine fractures underwent arthroscopic anterior row suture fixation using knotless anchors. Functional outcomes as Lysholm, Internation Knee Documentation Committee rating score (IKDC), Range of motion (ROM), stability, and radiological healing were assessed over 24 months. Results All patients achieved radiographic union (mean: 16 weeks). Final follow‐up showed restoration of pre‐injury Lysholm (94 ± 5 to 93.6 ± 0.8), IKDC (84 ± 7 to 83.9 ± 0.7), and ROM (142°–140°). No instability, growth disturbance, or hardware‐related complications were observed. Conclusion This technique provides stable fixation, preserves the physis, and avoids intra‐articular hardware. Functional and radiological outcomes were excellent, supporting arthroscopic suture fixation as a safe and effective option for tibial spine avulsion fractures. Level of Evidence Level III, prospective study.