Skip to main content
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 10/2019

18.01.2019 | KNEE

Immediate arthroscopy following ORIF for tibial plateau fractures provide early diagnosis and treatment of the combined intra-articular pathologies

verfasst von: Jae-Jung Jeong, Seung-bae Oh, Jong-Hun Ji, Seok-Jae Park, Myung-Sup Ko

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 10/2019

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To evaluate the effectiveness of immediate arthroscopy and clinical outcomes following open reduction and internal fixation (ORIF) of tibial plateau fractures.

Methods

Sixty patients (36 men and 24 women, median age 56 (20–78) years) were divided into Group I (ORIF only: 26 patients, median age 58 (25–78) years) or Group II (ORIF with immediate arthroscopy: 34 patients, median age 55 (20–75) years) in tibial plateau fractures (Schatzker Type II–VI fractures). In the first part of this study, ORIF only was performed without arthroscopic treatment. In the second part, ORIF with immediate arthroscopic examination and treatment was performed. Clinical outcomes, utilizing range of motion (ROM), International Knee Documentation Committee (IKDC) score and hospital for special knee score (HSS) were assessed.

Results

At the final follow-up, HSS score was 81 ± 11 points in Group I and 83 ± 9 points in Group II. The IKDC score was 85 ± 8 points in Group I and 86 ± 6 points in Group II. In Group II, concomitant intra-articular lesions in 10 patients (29%) were found and treated simultaneously. However, there were no significant differences in clinical scores or ROM between the two groups.

Conclusion

Immediate arthroscopy following ORIF for tibial plateau fracture is an effective procedure that provides accurate information for fracture reduction, leading to immediate treatment of concomitant intra-articular lesions without complications.

Level of evidence

III.
Literatur
1.
Zurück zum Zitat Arnold JB, Tu CG, Phan TM, Rickman M, Varghese VD, Thewlis D, Solomon LB (2017) Characteristics of postoperative weight bearing and management protocols for tibial plateau fractures: findings from a scoping review. Injury 48(12):2634–2642CrossRefPubMed Arnold JB, Tu CG, Phan TM, Rickman M, Varghese VD, Thewlis D, Solomon LB (2017) Characteristics of postoperative weight bearing and management protocols for tibial plateau fractures: findings from a scoping review. Injury 48(12):2634–2642CrossRefPubMed
2.
Zurück zum Zitat Barenius B, Ponzer S, Shalabi A, Bujak R, Norlen L, Eriksson K (2014) Increased risk of osteoarthritis after anterior cruciate ligament reconstruction: a 14-year follow-up study of a randomized controlled trial. Am J Sports Med 42(5):1049–1057CrossRefPubMed Barenius B, Ponzer S, Shalabi A, Bujak R, Norlen L, Eriksson K (2014) Increased risk of osteoarthritis after anterior cruciate ligament reconstruction: a 14-year follow-up study of a randomized controlled trial. Am J Sports Med 42(5):1049–1057CrossRefPubMed
3.
Zurück zum Zitat Burdin G (2013) Arthroscopic management of tibial plateau fractures: surgical technique. Orthop Traumatol Surg Res 99(1 Suppl):S208–S218CrossRefPubMed Burdin G (2013) Arthroscopic management of tibial plateau fractures: surgical technique. Orthop Traumatol Surg Res 99(1 Suppl):S208–S218CrossRefPubMed
4.
Zurück zum Zitat Chen XZ, Liu CG, Chen Y, Wang LQ, Zhu QZ, Lin P (2015) Arthroscopy-assisted surgery for tibial plateau fractures. Arthroscopy 31(1):143–153CrossRefPubMed Chen XZ, Liu CG, Chen Y, Wang LQ, Zhu QZ, Lin P (2015) Arthroscopy-assisted surgery for tibial plateau fractures. Arthroscopy 31(1):143–153CrossRefPubMed
5.
Zurück zum Zitat Chiu CH, Cheng CY, Tsai MC, Chang SS, Chen AC, Chen YJ, Chan YS (2013) Arthroscopy-assisted reduction of posteromedial tibial plateau fractures with buttress plate and cannulated screw construct. Arthroscopy 29(8):1346–1354CrossRefPubMed Chiu CH, Cheng CY, Tsai MC, Chang SS, Chen AC, Chen YJ, Chan YS (2013) Arthroscopy-assisted reduction of posteromedial tibial plateau fractures with buttress plate and cannulated screw construct. Arthroscopy 29(8):1346–1354CrossRefPubMed
6.
Zurück zum Zitat Dejour H, Walch G, Deschamps G, Chambat P (2014) Arthrosis of the knee in chronic anterior laxity. Orthop Traumatol Surg Res 100(1):49–58CrossRefPubMed Dejour H, Walch G, Deschamps G, Chambat P (2014) Arthrosis of the knee in chronic anterior laxity. Orthop Traumatol Surg Res 100(1):49–58CrossRefPubMed
7.
Zurück zum Zitat Egol KA, Cantlon M, Fisher N, Broder K, Reisgo A (2017) Percutaneous repair of a Schatzker III Tibial plateau fracture assisted by arthroscopy. J Orthop Trauma 31(Suppl 3):S12–S13CrossRefPubMed Egol KA, Cantlon M, Fisher N, Broder K, Reisgo A (2017) Percutaneous repair of a Schatzker III Tibial plateau fracture assisted by arthroscopy. J Orthop Trauma 31(Suppl 3):S12–S13CrossRefPubMed
8.
Zurück zum Zitat Gamulin A, Lubbeke A, Belinga P, Hoffmeyer P, Perneger TV, Zingg M, Cunningham G (2017) Clinical and radiographic predictors of acute compartment syndrome in the treatment of tibial plateau fractures: a retrospective cohort study. BMC Musculoskelet Disord 18(1):307CrossRefPubMedPubMedCentral Gamulin A, Lubbeke A, Belinga P, Hoffmeyer P, Perneger TV, Zingg M, Cunningham G (2017) Clinical and radiographic predictors of acute compartment syndrome in the treatment of tibial plateau fractures: a retrospective cohort study. BMC Musculoskelet Disord 18(1):307CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Guanche CA, Markman AW (1993) Arthroscopic management of tibial plateau fractures. Arthroscopy 9(4):467–471CrossRefPubMed Guanche CA, Markman AW (1993) Arthroscopic management of tibial plateau fractures. Arthroscopy 9(4):467–471CrossRefPubMed
10.
Zurück zum Zitat Hegenscheid K, Puls R, Rosenberg C (2012) Imaging strategies for knee injuries. Radiologe 52(11):980–986CrossRefPubMed Hegenscheid K, Puls R, Rosenberg C (2012) Imaging strategies for knee injuries. Radiologe 52(11):980–986CrossRefPubMed
11.
Zurück zum Zitat Hohl MLR (1991) Fractures of the knee. In: Rockwood CA Jr, Green DP, Bucholz RW (eds) Fractures in adults, vol 2. JB Lippincott, Philadelphia, pp 1725–1757 Hohl MLR (1991) Fractures of the knee. In: Rockwood CA Jr, Green DP, Bucholz RW (eds) Fractures in adults, vol 2. JB Lippincott, Philadelphia, pp 1725–1757
12.
Zurück zum Zitat Krause M, Preiss A, Meenen NM, Madert J, Frosch KH (2016) “Fracturoscopy” is superior to fluoroscopy in the articular reconstruction of complex Tibial Plateau fractures—an arthroscopy assisted fracture reduction technique. J Orthop Trauma 30(8):437–444CrossRefPubMed Krause M, Preiss A, Meenen NM, Madert J, Frosch KH (2016) “Fracturoscopy” is superior to fluoroscopy in the articular reconstruction of complex Tibial Plateau fractures—an arthroscopy assisted fracture reduction technique. J Orthop Trauma 30(8):437–444CrossRefPubMed
13.
Zurück zum Zitat Li JW, Ye F, Bi DW, Zheng XD, Chen JL (2018) Treatment of Schatzker IV tibial plateau fractures with arthroscopy combined with MIPPO technique. Zhongguo Gu Shang 31(2):186–189PubMed Li JW, Ye F, Bi DW, Zheng XD, Chen JL (2018) Treatment of Schatzker IV tibial plateau fractures with arthroscopy combined with MIPPO technique. Zhongguo Gu Shang 31(2):186–189PubMed
14.
Zurück zum Zitat Liao W, Li Z, Zhang H, Li J, Wang K, Yang Y (2016) Arthroscopic fixation of tibial eminence fractures: a clinical comparative study of nonabsorbable sutures versus absorbable suture anchors. Arthroscopy 32(8):1639–1650CrossRefPubMed Liao W, Li Z, Zhang H, Li J, Wang K, Yang Y (2016) Arthroscopic fixation of tibial eminence fractures: a clinical comparative study of nonabsorbable sutures versus absorbable suture anchors. Arthroscopy 32(8):1639–1650CrossRefPubMed
15.
Zurück zum Zitat Madelaine A, Fournier G, Sappey-Marinier E, Madelaine T, Seil R, Lefevre N, Chotel F (2018) Conservative management of anterior cruciate ligament injury in paediatric population: about 53 patients. Orthop Traumatol Surg Res 104(8S):S169–S173CrossRefPubMed Madelaine A, Fournier G, Sappey-Marinier E, Madelaine T, Seil R, Lefevre N, Chotel F (2018) Conservative management of anterior cruciate ligament injury in paediatric population: about 53 patients. Orthop Traumatol Surg Res 104(8S):S169–S173CrossRefPubMed
16.
Zurück zum Zitat Markhardt BK, Gross JM, Monu JU (2009) Schatzker classification of tibial plateau fractures: use of CT and MR imaging improves assessment. Radiographics 29(2):585–597CrossRefPubMed Markhardt BK, Gross JM, Monu JU (2009) Schatzker classification of tibial plateau fractures: use of CT and MR imaging improves assessment. Radiographics 29(2):585–597CrossRefPubMed
17.
18.
Zurück zum Zitat McNamara IR, Smith TO, Shepherd KL, Clark AB, Nielsen DM, Donell S, Hing CB (2015) Surgical fixation methods for tibial plateau fractures. Cochrane Database Syst Rev 9:CD009679 McNamara IR, Smith TO, Shepherd KL, Clark AB, Nielsen DM, Donell S, Hing CB (2015) Surgical fixation methods for tibial plateau fractures. Cochrane Database Syst Rev 9:CD009679
19.
Zurück zum Zitat Mellema JJ, Doornberg JN, Molenaars RJ, Ring D, Kloen P (2016) Tibial plateau fracture characteristics: reliability and diagnostic accuracy. J Orthop Trauma 30(5):e144–e151CrossRefPubMed Mellema JJ, Doornberg JN, Molenaars RJ, Ring D, Kloen P (2016) Tibial plateau fracture characteristics: reliability and diagnostic accuracy. J Orthop Trauma 30(5):e144–e151CrossRefPubMed
20.
Zurück zum Zitat Mendel T, Wohlrab D, Hofmann GO (2011) Acute compartment syndrome of the lower leg due to knee arthroscopy. Orthopade 40(10):925–928CrossRefPubMed Mendel T, Wohlrab D, Hofmann GO (2011) Acute compartment syndrome of the lower leg due to knee arthroscopy. Orthopade 40(10):925–928CrossRefPubMed
21.
Zurück zum Zitat Mthethwa J, Chikate A (2017) A review of the management of tibial plateau fractures. Musculoskelet Surg 102:119–127CrossRefPubMed Mthethwa J, Chikate A (2017) A review of the management of tibial plateau fractures. Musculoskelet Surg 102:119–127CrossRefPubMed
22.
Zurück zum Zitat Padanilam TG, Ebraheim NA, Frogameni A (1995) Meniscal detachment to approach lateral tibial plateau fractures. Clin Orthop Relat Res 314:192–198 Padanilam TG, Ebraheim NA, Frogameni A (1995) Meniscal detachment to approach lateral tibial plateau fractures. Clin Orthop Relat Res 314:192–198
25.
Zurück zum Zitat Pitta GB, Dos Santos TF, Dos Santos FT, da Costa Filho EM (2014) Compartment syndrome after tibial plateau fracture. Rev Bras Ortop 49(1):86–88CrossRefPubMedPubMedCentral Pitta GB, Dos Santos TF, Dos Santos FT, da Costa Filho EM (2014) Compartment syndrome after tibial plateau fracture. Rev Bras Ortop 49(1):86–88CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat Sanders TL, Pareek A, Barrett IJ, Kremers HM, Bryan AJ, Stuart MJ, Levy BA, Krych AJ (2017) Incidence and long-term follow-up of isolated posterior cruciate ligament tears. Knee Surg Sports Traumatol Arthrosc 25(10):3017–3023CrossRefPubMed Sanders TL, Pareek A, Barrett IJ, Kremers HM, Bryan AJ, Stuart MJ, Levy BA, Krych AJ (2017) Incidence and long-term follow-up of isolated posterior cruciate ligament tears. Knee Surg Sports Traumatol Arthrosc 25(10):3017–3023CrossRefPubMed
27.
Zurück zum Zitat Sanders TL, Pareek A, Kremers HM, Bryan AJ, Levy BA, Stuart MJ, Dahm DL, Krych AJ (2017) Long-term follow-up of isolated ACL tears treated without ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 25(2):493–500CrossRefPubMed Sanders TL, Pareek A, Kremers HM, Bryan AJ, Levy BA, Stuart MJ, Dahm DL, Krych AJ (2017) Long-term follow-up of isolated ACL tears treated without ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 25(2):493–500CrossRefPubMed
28.
Zurück zum Zitat Thabet AM, Simson JE, Gerzina C, Dabash S, Adler A, Abdelgawad AA (2018) The impact of acute compartment syndrome on the outcome of tibia plateau fracture. Eur J Orthop Surg Traumatol 28(1):85–93CrossRefPubMed Thabet AM, Simson JE, Gerzina C, Dabash S, Adler A, Abdelgawad AA (2018) The impact of acute compartment syndrome on the outcome of tibia plateau fracture. Eur J Orthop Surg Traumatol 28(1):85–93CrossRefPubMed
30.
Zurück zum Zitat Weinlein J, Schmidt A (2010) Acute compartment syndrome in tibial plateau fractures–beware! J Knee Surg 23(1):9–16CrossRefPubMed Weinlein J, Schmidt A (2010) Acute compartment syndrome in tibial plateau fractures–beware! J Knee Surg 23(1):9–16CrossRefPubMed
31.
Zurück zum Zitat Zeltser DW, Leopold SS (2013) Classifications in brief: Schatzker classification of tibial plateau fractures. Clin Orthop Relat Res 471(2):371–374CrossRefPubMed Zeltser DW, Leopold SS (2013) Classifications in brief: Schatzker classification of tibial plateau fractures. Clin Orthop Relat Res 471(2):371–374CrossRefPubMed
Metadaten
Titel
Immediate arthroscopy following ORIF for tibial plateau fractures provide early diagnosis and treatment of the combined intra-articular pathologies
verfasst von
Jae-Jung Jeong
Seung-bae Oh
Jong-Hun Ji
Seok-Jae Park
Myung-Sup Ko
Publikationsdatum
18.01.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 10/2019
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-019-05345-1

Weitere Artikel der Ausgabe 10/2019

Knee Surgery, Sports Traumatology, Arthroscopy 10/2019 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.