Table 2.

Advantages and Disadvantages of Suture Fixation With Double Hewson Suture Passer

Advantages	Disadvantages
Eliminates need for intra-articular hardware.	Passing suture through anterior cruciate ligament and 2 Hewson sutures simultaneously may be technically challenging.
Eliminates risk for suture anchor pullout in short and long term.	Fixation relies on using fracture fragment as bony bridge, may not hold reduction if fragment is comminuted.
Once suture is passed through Hewson suture passers, no further suture retrieval is required.	Misplacement of drill holes may lead to over-/underreduction.
Low cost: procedure could be completed simply with suture, eliminating need for implant associated cost.	Accessory incisions needed for tibial drill holes versus an all-inside suture anchor technique.
Good clinical evidence for positive outcomes with suture-only fixation.2, 1, 11
Can use nonabsorbable or absorbable sutures.