Prospective follow-up of a simple arthroscopic-assisted technique for lateral tibial plateau fractures: results at 5 years

Knee. 2008 Oct;15(5):378-83. doi: 10.1016/j.knee.2008.04.001. Epub 2008 Jun 20.

Abstract

This study reports the 5-year clinical and radiological outcomes of a simple arthroscopic-assisted technique for Schatzker types II and III tibial plateau fractures, without bone grafting. Forty six patients (46% males, 54% females, average age 48 years, SD 13.6 years), with tibial plateau fractures Schatzker types II (41%) and III (59%), underwent an arthroscopic-assisted technique conceived to use a compacted cancellous bone graft, taken from the medial metaphyseal side of the tibia, and a percutaneous fixation. The patients were prospectively followed-up at 1, 3 and 5 years from surgery. Independent assessments were carried out using Knee Society Score, HSS score and Rasmussen's clinical and radiological scores. At 5-year follow-up patients underwent a weight-bearing radiograph of both limbs. At last follow-up evaluation Knee Score (average 93.2, SD 7.7) was excellent in 37 patients (80%), good in six (13%), fair in three (7%). Function Score (average 94.8, SD 8.51) was excellent in 38 patients (83%), good in five (11%), fair in three (6%). HSS score (average 93.4, SD 8.23) was excellent in 41 patients (89%), good in five (11%). The average Rasmussen clinical score was 28.2 (SD 1.4). The radiological Rasmussen score was excellent in five patients (11%), good in 39 (85%) and fair in two (4%). In the weight-bearing radiographs a valgus deviation was present in four patients (8.7%). This technique has outcomes encouraging and comparable to the results of other techniques that use either iliac crest graft or bone substitutes.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Arthroscopy / methods*
  • Bone Nails
  • Bone Screws
  • Female
  • Follow-Up Studies
  • Fracture Fixation, Internal / methods*
  • Humans
  • Knee Injuries / diagnostic imaging
  • Knee Injuries / physiopathology
  • Knee Injuries / surgery
  • Male
  • Middle Aged
  • Prospective Studies
  • Radiography
  • Range of Motion, Articular / physiology
  • Tibial Fractures / diagnostic imaging
  • Tibial Fractures / surgery*
  • Time Factors
  • Treatment Outcome