2022
DOI: 10.1007/s00167-022-07282-y
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Extent of posterolateral tibial plateau impaction fracture correlates with anterolateral complex injury and has an impact on functional outcome after ACL reconstruction

Abstract: Purpose The impact of posterolateral tibial plateau impaction fractures (TPIF) on posttraumatic knee stability in the setting of primary anterior cruciate ligament (ACL) tear is unknown. The main objective was to determine whether increased bone loss of the posterolateral tibial plateau is associated with residual rotational instability and impaired functional outcome after ACL reconstruction. Methods A cohort was identified in a prospective enrolled study… Show more

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Cited by 12 publications
(11 citation statements)
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References 39 publications
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“…Regarding the potential effects of these fractures on the clinical outcomes following isolated ACL‐R, Bernholt et al [3] found that high‐grade PLTP fractures are associated with lower Lysholm scores at 2 years postoperatively, suggesting that these fractures could have significant clinical relevance. This was further confirmed in the recent study from Flury et al [13], who showed that the extent of these fractures correlates with the injury to the anterolateral complex and has an impact on functional outcomes following an ACL reconstruction. However, additional clinical studies are necessary to conclusively determine whether an isolated ACL‐R in cases of high‐grade PLTP fracture concomitancy can fully restore the stability of the joint and, if not, what effect this potential residual laxity has on the postoperative functional and patient‐reported outcomes.…”
Section: Discussionsupporting
confidence: 64%
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“…Regarding the potential effects of these fractures on the clinical outcomes following isolated ACL‐R, Bernholt et al [3] found that high‐grade PLTP fractures are associated with lower Lysholm scores at 2 years postoperatively, suggesting that these fractures could have significant clinical relevance. This was further confirmed in the recent study from Flury et al [13], who showed that the extent of these fractures correlates with the injury to the anterolateral complex and has an impact on functional outcomes following an ACL reconstruction. However, additional clinical studies are necessary to conclusively determine whether an isolated ACL‐R in cases of high‐grade PLTP fracture concomitancy can fully restore the stability of the joint and, if not, what effect this potential residual laxity has on the postoperative functional and patient‐reported outcomes.…”
Section: Discussionsupporting
confidence: 64%
“…It has been reported that an increase in translation of the lateral compartment of the knee is directly correlated with the extent of knee pivoting, meaning that injuries to the lateral stabilizing structures of the knee, including the anterolateral capsule with the anterolateral capsular ligament (ALCL), ITT and LM [1, 2, 17, 23, 24], as well as increase in tibial slope result in higher grades of ALR instability [12, 13, 26].…”
Section: Discussionmentioning
confidence: 99%
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“…While we agree with Krause et al [8] that prior studies have demonstrated increased rotatory knee instability in patients with larger posterolateral tibial plateau fractures, the prior studies utilized subjective grading of the pivot shift intraoperatively [2, 3]. This method of measurement is variable and highly subjective, which can certainly add bias to the results.…”
supporting
confidence: 76%
“…Moreover, specific types of PTPF combined with ACL tear have been noted to affect not only pivot-shift laxity under anesthesia but also the postoperative outcomes of ACL reconstruction. 4 , 8 Given the close association between fractures and ACL injuries with knee osteoarthritis, 27 , 32 a holistic solution that addresses both factors is needed.…”
Section: Discussionmentioning
confidence: 99%