PROSPECTIVE RESULTS OF AN ARTHROSCOPIC-ASSISTED TECHNIQUE FOR LATERAL TIBIAL PLATEAU FRACTURES

Abstract

This study reports the 5-year clinical and radiological outcomes of a simple arthroscopic-assisted technique for Schatzker type 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 type 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 one, three and five 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%).

Arthroscopic-assisted technique for lateral tibial plateau fractures without bone grafting has outcomes encouraging and comparable to the results of other techniques that use either iliac crest graft or bone substitutes.