Influence of reduction quality on functional outcome and quality of life in the surgical treatment of tibial plateau fractures: A retrospective cohort study

Beisemann, Nils; Vetter, Sven; Keil, Holger; Swartman, Benedict; Schnetzke, Marc; Franke, Jochen; Grützner, Paul Alfred; Privalov, Maxim

doi:10.1016/j.otsr.2021.102922

Cited by 9 publications

(7 citation statements)

References 52 publications

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“…Poorer results can be expected following serve and complex TPF. Furthermore, patients with a smaller amount of postoperative articular step-off tend to have a better functional outcome [1,23,26]. Patients with hardware removal indicated a lower KOOS, which was statistically significant.…”

Section: Discussionmentioning

confidence: 87%

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Tibial plateau fractures are associated with poor functional outcomes and a low conversion rate to total knee arthroplasty

Kraml,

Haslhofer,

Winkler

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThe aim of this study was to analyse the functional outcome and the conversion rate to total knee arthroplasty (TKA) after surgically treated tibial plateau fractures (TPF).MethodsAll patients undergoing surgical treatment of TPF at a single institution between January 2003 and December 2019 were retrospectively reviewed. The Knee injury and Osteoarthritis Outcome Score (KOOS) and Tegner activity scale (TAS) were collected. The conversion rate to TKA was examined 2, 5, 7 and 10 years after surgical treatment of TPF.ResultsNinety‐four patients, with a mean follow‐up of 110.6 months (±60.0), were included in the functional outcome assessment. Mean KOOS scores were 75.4 for symptoms, 80.6 for pain, 84.3 for activities of daily living (ADL), 59.5 for sports and 61.3 for QOL. All subscales were significantly lower on the injured side compared with the contralateral leg. Lower KOOS was observed in patients with hardware removal and Schatzker type 5 and 6 injuries. Median TAS was postinjury (4) significantly lower than preinjury (5) (p < 0.001). The conversion rate to TKA was 6.3%, 10.9%, 11.7% and 12.2% after 2,5,7 and 10 years of follow‐up, respectively. Patients undergoing TKA were older than patients with no conversion to TKA (2 years follow‐up 53.8 vs. 64.5 years, p = 0.026).ConclusionTPFs decrease the function of the knee when compared with the contralateral side and to the preoperative condition. Bicondylar fractures are associated with worse functional outcomes. A conversion rate to TKA of 12.2% was found at 10 years follow‐up.Level of EvidenceLevel III.

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Section: Discussionmentioning

confidence: 87%

“…Poorer results can be expected following serve and complex TPF. Furthermore, patients with a smaller amount of postoperative articular step‐off tend to have a better functional outcome [1, 23, 26].…”

Section: Discussionmentioning

confidence: 99%

Tibial plateau fractures are associated with poor functional outcomes and a low conversion rate to total knee arthroplasty

Kraml,

Haslhofer,

Winkler

et al. 2024

Knee surg. sports traumatol. arthrosc.

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“…Die zunehmende Verfügbarkeit intraoperativer 3-D-Bildgebung ist eine wertvolle Ergänzung des klinischen Blickes und erlaubt die Korrektur von verbliebenden Gelenkstufen. Der Zeitaufwand hält sich dabei mit 5-10 min pro Durchführung in Grenzen, und es konnte eine wesentliche Verbesserung des Repositionsergebnisses und funktionellen Outcomes gezeigt werden [21,22].…”

Section: Merkeunclassified

Intraoperative Repositionstechniken bei Osteosynthesen von Extremitätenfrakturen

Gramlich,

Schnetz,

Hoffmann

et al. 2024

Orthopädie und Unfallchirurgie up2date

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“…The fundamental principles of osteosynthetic treatment aim to achieve the most accurate possible joint surface reduction and anatomical reconstruction of both the width of the tibial head, joint angles, and limb alignment. In 1973, Rasmussen described how these parameters significantly impact patient outcomes [6], a finding that was subsequently validated by Kraus et al and Beisemann et al in the past years [5,7]. Additionally, Rasmussen developed a clinical-functional outcome score that is not reliant on radiological parameters [6].…”

Section: Introductionmentioning

confidence: 99%

Mismatch between Clinical–Functional and Radiological Outcome in Tibial Plateau Fractures: A Retrospective Study

Bormann,

Bitschi,

Neidlein

et al. 2023

JCM

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Background: The evaluation of tibial plateau fractures (TPF) encompasses the assessment of clinical–functional and radiological parameters. In this study, the authors aimed to investigate the potential correlation between these parameters by utilizing both the clinical–functional and the modified radiological Rasmussen score. Methods: In this retrospective monocentric study conducted at a level-I trauma center, patients who underwent surgery between January 2014 and December 2019 due to a TPF were included. The clinical–functional Rasmussen score prior to the injury, at 1-year postoperatively, and during the last follow-up (minimum 18 months) was assessed using a standardized questionnaire. Additionally, the modified radiological Rasmussen score was determined at the 1-year postoperative mark using conventional radiographs in two planes. Results: A total of 50 patients were included in this study, comprising 40% (n = 20) men, and 60% (n = 30) women, with an average age of 47 ± 11.8 years (range 26–73 years old). Among them, 52% (n = 26) had simple fractures (classified according to Schatzker I–III), while 48% (n = 24; according to Schatzker IV–VI) had complex fractures. The mean follow-up was 3.9 ± 1.6 years (range 1.6–7.5 years). The functional Rasmussen score assessed before the injury and at follow-up showed an “excellent” average result. However, there was a significant difference in the values of complex fractures compared to before the injury. One year postoperatively, both the clinical–functional score and the modified radiological score demonstrated a “good” average result. The “excellent” category was more frequently observed in the functional score, while the “fair” category was more common in the radiological score. There was no agreement between the categories in both scores in 66% of the cases. Conclusions: The data from this retrospective study demonstrated that patients with TPF are able to achieve a nearly equivalent functional level in the medium-term after a prolonged recovery period, comparable to their pre-injury state. However, it is important to note that the correlation between clinical–functional and radiological parameters is limited. Consequently, in order to create prospective outcome scores, it becomes crucial to objectively assess the multifaceted nature of TPF injuries in more detail, both clinically and radiologically.

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Influence of reduction quality on functional outcome and quality of life in the surgical treatment of tibial plateau fractures: A retrospective cohort study

Cited by 9 publications

References 52 publications

Tibial plateau fractures are associated with poor functional outcomes and a low conversion rate to total knee arthroplasty

Tibial plateau fractures are associated with poor functional outcomes and a low conversion rate to total knee arthroplasty

Intraoperative Repositionstechniken bei Osteosynthesen von Extremitätenfrakturen

Mismatch between Clinical–Functional and Radiological Outcome in Tibial Plateau Fractures: A Retrospective Study

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