Posterior cruciate ligament (PCL) avulsion fracture of the tibia is an uncommon but serious complication during primary cruciate-retaining total knee arthroplasty (TKA). The first objective of this report was to conduct a retrospective cohort study to investigate the incidence and potential risk factors of PCL avulsion fracture in primary cruciate-retaining TKA. The second objective was to assess the functional outcomes of the knee after reduction of PCL avulsion fracture. From January 2014 to January 2016, 56 patients who experienced PCL avulsion fracture of the tibia in primary cruciate-retaining TKA were included in the study group. Patients in this group underwent reduction of avulsion fracture. In this period, we selected 224 patients (control group) for comparison. Patients in this group also underwent the same TKA, but no PCL avulsion fracture occurred. The range of motion of the knee and Knee Society Scores were assessed. The Forgotten Joint Score was used to analyze the ability to forget the joint. Differences were considered statistically significant at p < 0.05. In our series, the incidence of PCL avulsion fracture was 4.6%. There were no significant differences (p > 0.05) with regard to the preoperative or postoperative range of motion of the knee, final 4-year mean clinical score in the study and control groups 92.4 ± 2.7 and 93.6 ± 1.9, respectively, and mean functional scores of 85.1 ± 1.8 and 87.1 ± 1.2, respectively. The incidence of PCL avulsion fracture of the tibia is relatively high. Older age and female gender were the two risk factors of fracture in primary cruciate-retaining TKA. Reduction of PCL avulsion fracture with a high-strength line can achieve good stability and function of the knee.

中文翻译：

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全膝关节置换术后后交叉韧带撕脱性骨折的手术复位技术：一项比较研究。

胫骨后交叉韧带（PCL）撕脱骨折是一种罕见的但严重的并发症，在原发性保留交叉韧带的全膝关节置换术（TKA）中发生。本报告的首要目的是进行回顾性队列研究，以调查保留原位十字形的TKA中PCL撕脱性骨折的发生率和潜在危险因素。第二个目标是评估PCL撕脱性骨折复位后膝盖的功能结局。从2014年1月至2016年1月，研究组纳入了56例在原发性十字形保留TKA中发生胫骨PCL撕脱性骨折的患者。该组患者的撕脱骨折减少。在此期间，我们选择了224例患者（对照组）进行比较。该组患者也接受了相同的TKA，但未发生PCL撕脱骨折。评估了膝盖的运动范围和膝关节社会评分。被遗忘的关节评分用于分析遗忘关节的能力。差异被认为具有统计学意义，p <0.05。在我们的系列中，PCL撕脱性骨折的发生率为4.6％。在研究组和对照组中，膝关节的术前或术后运动范围，最终4年平均临床评分分别为92.4±2.7和93.6±1.9，以及平均功能无明显差异（p> 0.05）。得分分别为85.1±1.8和87.1±1.2。胫骨PCL撕脱性骨折的发生率相对较高。老年和女性是保留原发性十字形TKA的两个骨折危险因素。