The hip allows mobility of the entire extremity in 3 planes. Therefore any little derangement in the anatomy of the hip can affect it's functioning and can cripple & severely affect daily living of the person. The most common causes of disability are trauma and degenerative disease, and till date the most successful2 treatment for joints severely damaged has been replacement by artificial parts. Today replacement arthroplasties are very commonly performed by orthopedic surgeons the world over. In India too this procedure has gained wide acceptance among both surgeons and patients. The primary goal of this procedure is to restore normal anatomy of the hip joint so as to provide painless free mobility with a stable hip, and immediate functional outcomes of this procedure are very satisfactory. Technically there is little debate that the results of revision procedure are less satisfactory and the primary THR offers the best chances of success. Therefore it would be rational to assess and eliminate the human/iatrogenic factors that would-be influencing and jeopardizing the longevity of the implant since such surgeries in Indian patients are mostly once in a lifetime job. Also since the indications of arthroplasty have expanded and more surgeries are being done, so there is a statistic increase in the percentage of loose implants, which ever the reason. Although definite evidence and impact of loosing manifests late but the parameters reflecting the causative factors can be detected early in the form of altered anatomy and function. And repetitive cyclical loading of the implant in an unfavorable mechanical environment will over time, ultimately build up to a negative result.
INTRODUCTION: In the modern world,due to advent of high speed motor vehicles , high energy trauma
commonly involves the knee joint and results in complex tibial plateau fractures and associated
ligament and meniscal injuries . Proper diagnosis and management of these injuries reduced the chances of degenerative
changes around knee joint later on.
MATERIAL AND METHOD: A prospective study was conducted in the Department of Orthopaedics in a tertiary health care
center of western rajasthan from January 2018 to December 2020 . A total of eighty patients( 62 males: 18 females) with tibial
plateau fractures and associated soft tissue injuries were included .Patients were assessed both clinically and radiologically
and “ SCHATZKER'S classication was used to classify the tibial plateau fractures. Pre-operatively in every case CT-scan
was used to study fracture pattern and MRI was done to see fracture morphology and associated soft tissue injuries.
RESULT: A total 80 patient was included in our study,out of which 73 (91.25%) having ligaments( Cruciate and Collaterals) and
meniscal injury . Injury to the lateral meniscus was found most frequently in Schatzker II fracture (p<0.0006) and medial
meniscus in schatzker IV (p< 0.011). Variable association was shown by ACL and PCL injuries with tibial plateu fracture
morphology ,but as the grade of designation increases within schatzker classication as does the frequency of cruciate
ligament tear. Overall incidence of LCL rupture occurred least frequently in Schatzker II fractures (7 of 34; 20.5%), which was
statistically signicant (P < 0.01). Complete MCL tear occurred in 27( 33.7%) of all fractures and in 41% of Schatzker II fractures.
PLC tear had shown signicant association with medial tibial plateu fracture (schatzker IV).
CONCLUSION: The likelihood of the cruciate , collateral ligament and PLC injury increases as the grade of designation within
schatzker classication (schatzker I-VI). PLC injury had a signicant association with medial tibial plateu fracture (schatzker
IV) and MCL had a signicant association with lateral tibial plateau fracture .
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