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Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-03-2019 | Knee

A sub-meniscal arthrotomy improves the medium-term patient outcome of tibial plateau fractures

Authors: Richard E. Buckley, Prism Schneider, Paul J. Duffy, Shannon Puloski, Robert Korley, C. Ryan Martin

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 3/2019

Abstract

Purpose

This trial was conducted to determine the medium-term functional outcome of displaced tibial plateau fracture patients treated with closed fluoroscopic assisted reduction and internal fixation (CRIF) versus patients treated with standard open reduction with sub-meniscal arthrotomy and internal fixation (ORIF).

Methods

A prospective trial was conducted in adult patients with displaced AO/OTA 41 B and 41 C tibial plateau fractures. Patients were assigned to treatment based upon the standard treatment of the surgeon involved following the call schedule for the day, either CRIF or ORIF. Postoperative radiographs and CT were performed on all patients and patients were followed for a minimum of 2 years. Primary outcome measures were the KOOS, SMFA and SF-36.

Results

Seventy patients were recruited with 2 year follow-up on 35 patients in the CRIF group and 27 patients in the ORIF group. Postoperative CT scans showed that reductions were better with the ORIF group especially in the posterolateral quadrant as compared to the CRIF group. The frequency of mal-reductions was higher in the CRIF group. The KOOS, at two years, showed that the CRIF had significantly less good outcomes in the subcategories of SPORT (p = 0.03) and QOL (p = 0.01) measurements.

Conclusions

ORIF with a sub-meniscal arthrotomy provides better quality reductions and better medium-term results as compared to CRIF for tibial plateau fractures. This may provide more long-term benefit from osteoarthritic symptoms in this patient group.

Level of evidence

Therapeutic, Level 2.

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Title: A sub-meniscal arthrotomy improves the medium-term patient outcome of tibial plateau fractures
Authors: Richard E. Buckley
Prism Schneider
Paul J. Duffy
Shannon Puloski
Robert Korley
C. Ryan Martin
Publication date: 01-03-2019
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 3/2019
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-018-5122-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A sub-meniscal arthrotomy improves the medium-term patient outcome of tibial plateau fractures

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

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