Tibial plateau fractures: functional outcome and incidence of osteoarthritis in 125 cases

Manidakis, Nikolaos; Dosani, Anis; Dimitriou, Rozalia; Stengel, Dirk; Matthews, Stephen J.; Giannoudis, Peter V.

doi:10.1007/s00264-009-0790-5

Cited by 196 publications

(180 citation statements)

References 27 publications

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“…The relative small number of patients is another drawback. Additionally, there are studies that support the view that the incidence of post-traumatic degenerative osteoarthritis following intra-articular fractures of the knee tends to develop from six to eight years after injury [25]. Consequently, the follow-up period of this study is short, especially for the identification of such longterm complications.…”

Section: Discussionmentioning

confidence: 94%

Proximal tibial fractures: early experience using polyaxial locking-plate technology

Nikolaou

Tan

Haidukewych

et al. 2010

International Orthopaedics (SICOT)

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Section: Discussionmentioning

confidence: 94%

Proximal tibial fractures: early experience using polyaxial locking-plate technology

Nikolaou

Tan

Haidukewych

et al. 2010

International Orthopaedics (SICOT)

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“…Osteosynthesis failure with loss of reduction is a common complication resulting in post-traumatic osteoarthritis [12][13][14]. Implant anchorage close to the subchondral plate is an established method to improve the osteosynthesis due to better screw grip in the bone [15,16].…”

Section: Discussionmentioning

confidence: 99%

Subchondral screw abutment: does it harm the joint cartilage? An in vivo study on sheep tibiae

Goetzen

Hofmann‐Fliri

Arens

et al. 2017

International Orthopaedics (SICOT)

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Purpose Subchondral screw abutment in osteosynthesis of joint fractures is an effective method to achieve sufficient screw grip. In this study we investigated if subchondral screw placement is possible without harming the overlying subchondral plate and joint cartilage iatrogenic. Materials and Methods A 3.5-mm conventional steel screw was placed in the tibia of ten sheep in distances between 1 and 7 mm beneath the joint cartilage. After a follow up of two and four months, evaluation of the subchondral bone and joint cartilage was performed by means of a histological osteoarthritis score, HRpQCT imaging and determination of the glycosaminoglycan content in the cartilage. The control group was the contralateral knee of the same animal. Results Histomorphometric evaluation of the Mankin osteoarthritis score revealed no significant difference compared to the control after two (p = 0.102) and four months (p = 0.429).No correlation between distance of the screw to the cartilage and histological scoring was found (p = 0.658, R2 = 0.04 after two months and p = 0.171, R2 = 0.18 after four months). HRpQCT measurements of the subchondral thickness between screw and cartilage after two (p = 0.05) and four months (p = 0.424) showed no significant difference. Mean glycosaminoglycan content in the treatment group compared to the control after two months (p = 0.25) and four months (p = 0.523) was not significant different. Conclusion In conclusion subchondral screw abutment did not damage the joint cartilage after a two-and four-month follow up in this sheep model.

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“…Similarly, other studies reported requirement for anatomic reduction and stable fixation to achieve early mobilization and determinant of functional outcomes as postoperative ROM, joint stability and pain [11]- [13]. In addition sufficient cartilage nourishment is provided with stable fixation and early ROM [11]. Volpin et al reported that early motion might help prevent development of osteoarthritis [14].…”

Section: Introductionmentioning

confidence: 99%

“…Mitchell and Shepard point out precise intra-articular reduction and stable fixation of the fragments [10], while incorrect reduction and instability can cause rapid degeneration of the articular cartilage. Similarly, other studies reported requirement for anatomic reduction and stable fixation to achieve early mobilization and determinant of functional outcomes as postoperative ROM, joint stability and pain [11]- [13]. In addition sufficient cartilage nourishment is provided with stable fixation and early ROM [11].…”

Section: Introductionmentioning

confidence: 99%

Immediate Knee Joint Range of Motion after Stable Fixation of Tibial Plateau Fractures

Arslan¹,

Polat²,

Ciliz³

et al. 2015

OJO

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The purpose of this study was to evaluate factors that affect initiation of early postoperative range of motion (ROM) rehabilitation and to investigate whether the postoperative ROM and clinical outcomes were affected by initiation of early ROM, immobilization and other factors. We conducted a retrospective analysis of tibial plateau fractures treated using stable internal fixation between December 2003 and June 2007. The resulting degree of flexion and Rasmussen Clinical and Radiographic Scores were evaluated. Thirty-nine patients were included, and 23 patients underwent a lateral submeniscal arthrotomy for evaluation of joint surface reduction, with 6 lateral meniscus lesions identified via arthrotomy. Three lateral collateral ligament lesions, 3 medial collateral ligament lesions and 1 anterior cruciate ligament lesion were found. Meniscus and ligament lesions significantly and negatively affected the initiation of knee joint ROM. Early ROM was achieved in 26 cases and 13 patients underwent immobilization for 4 weeks. At the final evaluation, the early ROM group had 130.42˚ ± 5.50˚ of flexion, compared with 122.92˚ ± 5.28˚ in the immobilization group. Moreover, the final Rasmussen score was 25.69 ± 2.92 in the early motion group, compared with 22.61 ± 3.5 in the immobilization group. There was no difference between radiographic scores of the groups. Although the initiation of early ROM improved the clinical results, soft tissue lesions influenced initiation of early knee joint motion. Therefore, meniscus and ligament injuries should be considered as prognostic factors in similar cases.

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Tibial plateau fractures: functional outcome and incidence of osteoarthritis in 125 cases

Cited by 196 publications

References 27 publications

Proximal tibial fractures: early experience using polyaxial locking-plate technology

Proximal tibial fractures: early experience using polyaxial locking-plate technology

Subchondral screw abutment: does it harm the joint cartilage? An in vivo study on sheep tibiae

Immediate Knee Joint Range of Motion after Stable Fixation of Tibial Plateau Fractures

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