Research Article| Volume 50, ISSUE 3, P784-789, March 2019

Outcome of screw post fixation of neglected posterior cruciate ligament bony avulsions

Published:February 01, 2019DOI:


      • Neglected PCL bony avulsion injuries are rare.
      • The challenge with neglected cases is that the PCL is retracted and fibrosed.
      • Intra-articular release of the contracted ligament, burr hole drilling of the fracture bed, combined with the screw post fixation technique can achieve good results.



      Contrary to acute posterior cruciate ligament (PCL) bony tibial avulsions, surgical management of chronic injuries is technically challenging and appears to be controversial. We sought to assess the outcome of a novel screw post augmentation technique in neglected cases.


      16 patients were followed up in a tertiary single-center retrospective study. The bony fragment was fixed using a lag screw with a spiked washer and an additional screw post through an open posterior approach. The pre- and postoperative knee range of movement (ROM), laxity, and modified Tegner–Lysholm (TL) scores were compared.


      The median time from injury to surgery was 10 weeks (range, 3–260). The mean clinical follow-up time was 24.25 ± 9.21 months. At the final follow-up, the mean knee ROM flexion was 130° ± 11.55° with no extension lag. 3 patients had grade 1 laxity. The TL grade was predominantly excellent, and the overall median score improved from 76 preoperatively to 95 postoperatively (p < 0.0004). Bony union was achieved in all cases.


      The described screw post fixation technique results in an excellent outcome for these rare injuries.

      Level of evidence

      Level IV, case series.


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