Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 12 3 2026 07 16 131 4 Maziar Nafisi Knee Fellowship, Department of Orthopedic Surgery, Joint Reconstruction Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Hossein Ahmadzadeh Knee Fellowship, Department of Orthopedic Surgery, Joint Reconstruction Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Pouya Tabatabaei Irani Assistant Professor, Department of Orthopedic Surgery, Joint Reconstruction Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Mohammad Ayati Firoozabadi Associate Professor, Department of Orthopedic Surgery, Joint Reconstruction Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Seyed Mohammad Javad Mortazavi Professor, Department of Orthopedic Surgery, Joint Reconstruction Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran 2025 08 23 2026 06 01 Arthroscopic fixation using FiberWire sutures with a suture disc is a reliable, cost-effective, and minimally-invasive technique for managing anterior cruciate ligament (ACL) avulsion fractures, also known as tibial spine fractures (TSFs), which are uncommon but significant knee injuries that can lead to joint instability if left untreated. This retrospective case series evaluated the clinical outcomes of this approach in six patients (four men, two women; mean age: 22 years) with fractures classified using the modified Meyers and McKeever system. All patients underwent arthroscopic fixation and were followed for 9 months with serial radiographic and clinical assessments. Fracture union was achieved in all cases within three months, and five patients demonstrated negative Lachman and pivot shift tests, while one exhibited grade 1 positivity. The mean International Knee Documentation Committee (IKDC) score was 91.16 ± 4.61, with five patients graded as excellent and one as good. No complications were observed, highlighting the efficacy and safety of this technique across different age groups. https://jost.tums.ac.ir/index.php/jost/article/view/703 https://jost.tums.ac.ir/index.php/jost/article/download/703/475