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Context:A clinical case of a tibia plateau fracture is presented which was treated with balloon osteoplasty and arthroscopy guidance. Balloon Tibioplasty has been shown to be a very useful method for the management of tibial plateau fractures. The use of calcium phosphate has been described in the literature for management and restoration of bone defects in tibial plateau fractures.Case Report:A 45-years-old Caucasian woman was presented after a fall from a ladder. The patient sustained a lateral tibia plateau fracture which was classified as Shatzker type III (AO 41-B2) with posterolateral depression of the joint surface. Surgical treatment was applied using a minimal approach which included percutaneous reduction of the fracture under arthroscopy and fluoroscopy guidance. The bone defect was filled with calcium phosphate via injection. The clinical outcome at the 6, 12 and 24 weeks was excellent with full-range of motion of the knee joint.Conclusion:Arthroscopy assisted balloon osteoplasty seems to be a safe and effective method for the treatment of depressed tibia plateau fractures. Further study is needed for the proper evidence based use and application of this method.

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Background We set out to investigate whether anterior knee pain following anterior cruciate ligament reconstruction has a significant effect on patients, and whether it should influence graft choice. Methods This was a qualitative analysis of a set of recreational athletes treated at a university hospital at about 1 year following anterior cruciate ligament reconstruction surgery. Participants were interviewed by an orthopaedic fellow and resident using structured, open-ended questions. Inductive theme analysis was used to code the data. Results There were 4 major themes: (1) Our hypothesis was that patients would be given adequate information to make an appropriate graft choice. This hypothesis was rejected. Discussion took place, but with little details or rationale for the graft choice. The predominant theme was that the surgeon made the decision, and there was a lack of reliable information for the patient to make a choice. (2) The overall theme was that most patients had no anterior knee pain, and it did not interfere with activities of daily living. (3) One theme was that patients were able to resume all sports without restriction, but in some, the anterior knee pain interfered with the more demanding activities such as impact, cutting, and pivoting. A separate theme was that fear was a major impediment to return to sports and was not related to the anterior knee pain. (4) The overriding theme was that the generalized closures associated with the COVID-19 pandemic slowed the rehabilitation process. Although virtual care was available in general, it was not particularly satisfactory. Patients indicated that they had not been able to return to the gym or to their sporting activities as a result. Conclusions Amongst non-competitive athletes, anterior knee pain post-anterior cruciate ligament reconstruction surgery does not significantly affect activities of daily living. Although there is a minor effect on sporting activities, the inability to return to sports is related to factors such as the COVID-19 pandemic, fear, or insufficient rehabilitation, rather than anterior knee pain. Overall, anterior knee pain is not a significant factor that plays a role in determining graft choice.