Immediate arthroscopy following ORIF for tibial plateau fractures provide early diagnosis and treatment of the combined intra-articular pathologies

• Published in: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA Vol. 27; no. 10; pp. 3327 - 3333
• Main Authors: Jeong, Jae-Jung, Oh, Seung-bae, Ji, Jong-Hun, Park, Seok-Jae, Ko, Myung-Sup
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.10.2019; Springer Nature B.V
• Subjects: Adult; Age; Aged; Arthroscopy; Arthroscopy - methods; Clinical outcomes; Complications; Early Diagnosis; Female; Fracture Fixation, Internal - methods; Fractures; Humans; Knee; Knee Injuries - complications; Knee Injuries - diagnosis; Knee Injuries - diagnostic imaging; Knee Injuries - surgery; Lesions; Magnetic Resonance Imaging; Male; Medical diagnosis; Medicine; Medicine & Public Health; Middle Aged; Open Fracture Reduction - methods; Orthopedics; Patients; Performance evaluation; Range of Motion, Articular; Reduction; Tibial Fractures - complications; Tibial Fractures - diagnostic imaging; Tibial Fractures - physiopathology; Tibial Fractures - surgery; Time-to-Treatment; Tomography, X-Ray Computed; Tibial plateau fracture; Open reduction and internal fixation; Immediate arthroscopy; Intra-articular lesions
• ISSN: 0942-2056; 1433-7347
• DOI: 10.1007/s00167-019-05345-1

Purpose To evaluate the effectiveness of immediate arthroscopy and clinical outcomes following open reduction and internal fixation (ORIF) of tibial plateau fractures. Methods Sixty patients (36 men and 24 women, median age 56 (20–78) years) were divided into Group I (ORIF only: 26 patients, median age 58 (25–78) years) or Group II (ORIF with immediate arthroscopy: 34 patients, median age 55 (20–75) years) in tibial plateau fractures (Schatzker Type II–VI fractures). In the first part of this study, ORIF only was performed without arthroscopic treatment. In the second part, ORIF with immediate arthroscopic examination and treatment was performed. Clinical outcomes, utilizing range of motion (ROM), International Knee Documentation Committee (IKDC) score and hospital for special knee score (HSS) were assessed. Results At the final follow-up, HSS score was 81 ± 11 points in Group I and 83 ± 9 points in Group II. The IKDC score was 85 ± 8 points in Group I and 86 ± 6 points in Group II. In Group II, concomitant intra-articular lesions in 10 patients (29%) were found and treated simultaneously. However, there were no significant differences in clinical scores or ROM between the two groups. Conclusion Immediate arthroscopy following ORIF for tibial plateau fracture is an effective procedure that provides accurate information for fracture reduction, leading to immediate treatment of concomitant intra-articular lesions without complications. Level of evidence III.