【Abstract】Objective: To compare the effectiveness of posterior cruciate ligament (PCL) avulsion fracture at tibial insertion of knee joint with a adjustable titanium plate fixation and washer screw fixation. Methods :Retrospective analysis of 42 patients who underwent arthroscopic internal fixation of tibial insertion point avulsion fractures of the posterior cruciate ligament of the knee joint at Henan Provincial People''s Hospital from September 2020 to March 2023, meeting the inclusion criteria.Divided into two groups according to different fixation methods, 21 cases were fixed with adjustable titanium plates and 21 cases were fixed with washers and screws.Compare the time between the two groups from injury to surgery, surgery time, postoperative drainage volume, pain visual analogue score (VAS), knee range of motion (ROM), knee Lysholm score, and International Knee Joint Literature Committee (IKDC) score. Results: There was no statistically significant difference in injury to preoperative time, surgical time, postoperative drainage volume 2 days, VAS, ROM, Lysholm score, and IKDC score between the two groups. All patients were followed up for more than 6 months, with a follow-up time of 6~18 months. On the second day after surgery, knee joint CT was rechecked, and PCL tibial insertion point avulsion fractures were all reduced. No complications such as thrombosis, joint adhesion, stiffness, or infection occurred in the patients after surgery. Conclusion: There is no significant difference in clinical efficacy between the use of adjustable titanium plates and washers screws for internal fixation of posterior cruciate ligament avulsion fractures after arthroscopic treatment. Moreover, the use of arthroscopic treatment has minimal trauma, low complications, and fast functional recovery.