Comparative study between arthroscopic versus open fixation in posterior cruciate ligament avulsion fracture: A retrospective five-year review

Background: Posterior cruciate ligament (PCL) avulsion fractures are relatively uncommon injuries but can significantly impact knee stability and function if not appropriately managed. Both traditional open fixation and modern arthroscopic-assisted techniques are utilized in clinical practice. This study aims to compare the clinical outcomes of arthroscopic-assisted fixation versus open fixation for PCL avulsion fractures over a 5-year follow-up period. Materials and Methods: A retrospective comparative study was conducted involving 40 patients with displaced PCL avulsion fractures (>5 mm). Participants were equally allocated into two groups: open fixation ( n = 20) and arthroscopic-assisted fixation ( n = 20). Postoperative clinical outcomes were evaluated using the Lysholm Knee Scoring Scale at 3, 6, 9, and 12 months of follow-up. Results: The arthroscopic group showed significantly better Lysholm scores at 3 months (mean score: 82.4 vs. 74.6, P < 0.05), reflecting faster early recovery. However, by 12 months, both groups achieved comparable functional outcomes (arthroscopic: 94.1; open: 92.8; P > 0.05), with no statistically significant difference between them. Conclusion: Arthroscopic-assisted fixation provides superior early functional recovery with similar long-term outcomes when compared to open fixation. The minimally invasive nature of arthroscopic surgery may offer advantages in selected clinical settings with experienced surgical teams.