Repair of Meniscal Tears Associated With Tibial Plateau Fractures

Ibán, Miguel Ángel Ruiz; Díaz-Heredia, Jorge; Elías-Martín, Elena; Marco, Santos Moros; Val, Ignacio Cebreiro Martinez del

doi:10.1177/0363546512457552

Cited by 48 publications

(39 citation statements)

References 41 publications

(66 reference statements)

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“…Most studies have evaluated the success of managing a tibial plateau fracture by looking at radiographic and functional results [ 26 ]. The second-look arthroscopic evaluation not only provides a safe, quick, and accurate method of assessing outcomes, but it also provides the only way to show the healing of articular cartilage after a tibial plateau fracture has been treated [ 27 – 29 ]. So far, only three studies have used second-look arthroscopy to directly observe and assess the intra-articular structures after a tibial plateau fracture.…”

Section: Discussionmentioning

confidence: 99%

“…They found that the actual condition of the articular cartilage varied significantly, even in patients with a normal joint range of motion and good clinical and radiological results. Ruiz-Ibán et al [ 29 ] studied 13 patients who had undergone combined arthroscopic treatment for a tibial plateau fracture and a meniscal tear. One patient had a grade II lesion with a clear decrease in his activity level and a low adjusted IKDC (International Knee Documentation Committee) score attributable to a chondral lesion.…”

Section: Discussionmentioning

confidence: 99%

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Outcomes and second-look arthroscopic evaluation after combined arthroscopic treatment of tibial plateau and tibial eminence avulsion fractures: a 5-year minimal follow-up

Huang

Lee

Chen

et al. 2015

BMC Musculoskelet Disord

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BackgroundTibial eminence avulsion fracture often co-occurs with tibial plateau fracture, which leads to difficult concomitant management. The value of simultaneous arthroscopy-assisted treatment continues to be debated despite its theoretical advantages. We describe a simple arthroscopic suture fixation technique and hypothesize that simultaneous treatment is beneficial.MethodsPatients with a tibial eminence avulsion fracture and a concurrent tibial plateau fracture who underwent simultaneous arthroscopically assisted treatment between 2005 and 2008 were enrolled in this retrospective study. Second-look arthroscopic evaluation and Rasmussen scores of clinical and radiographic parameters were used to assess simultaneous treatment.ResultsForty-one patients (41 knees) met the inclusion criteria. All 41 fractures were successfully united. All patients had side-to-side differences of less than 3 mm and negative findings in Lachman and pivot-shift tests at their final follow-up. The mean postoperative Rasmussen clinical score was 27.3 (range: 19–30), and the mean radiologic score was 16.5 (range: 12–18). Clinical and radiographic outcomes in 98 % of the patients were good or excellent. There were no complications directly associated with arthroscopy in any patient.ConclusionsSimultaneous arthroscopic suture fixation of associated tibial eminence avulsion fracture did not interfere with the plates and screws used to stabilize the tibial plateau fracture. It gave the knee joint adequate stability, minimal surgical morbidity, and satisfactory radiographic and clinical outcomes in a minimum follow-up of 5 years and in the arthroscopic second-look assessments.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Outcomes and second-look arthroscopic evaluation after combined arthroscopic treatment of tibial plateau and tibial eminence avulsion fractures: a 5-year minimal follow-up

Huang

Lee

Chen

et al. 2015

BMC Musculoskelet Disord

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“…Recently emerged as a treatment option for tibial plateau fractures (Schatzker I-III), this method seems to be adopted by more and more surgeons in the world, as it benefits from the advantages of minimally invasive surgery - reduced hospitalization, faster recovery of knee mobility, reduced cutaneous complications [ 2 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Other lesions (external meniscus is damaged in about 30–50% of cases, lesions of cartilage or osteochondral lesions) can simultaneously benefit from specific treatment, improving patient recovery. Tears of the anterior cruciate ligament are also frequent, most of the time partial [ 2 , 4 , 5 , 6 , 7 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic management of proximal tibial fractures: technical note and case series presentation

Benea

Tomoaia

Martin

et al. 2015

Medicine and Pharmacy Reports

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Background and aimsThe purpose of this article is to describe a new surgical method of arthroscopy assisted treatment of intraarticular proximal tibial fractures (ARIF – arthroscopic reduction and internal fixation), analyzing its efficiency and safety on a series of patients. Tibial plateau fractures affect the proximal tibial metaphyseal and articular surface, representing 1.2% of all fractures and up to 8% of all fractures in elderly.Patients and methodOur case series consists of 6 patients with Schatzker types I-III tibial plateau fractures, treated in the Orthopedic and Traumatology Clinic of Cluj-Napoca from July 2012 to August 2014. Patients included in the study presented Schatzker type I-III tibial plateau fracture.ResultsThe results obtained with the arthroscopic method were excellent in 5 cases (mean Rasmussen score 27.60 points) and good in 1 case (mean score 23.75). The radiological consolidation appeared after a mean of 12 weeks. No major complication was noted.ConclusionsDiagnosis and treatment of associated lesions, shortening of hospitalization length and postoperative rehabilitation, but also the lower rate of complications, can make arthroscopic reduction and internal fixation the method of choice for the operative treatment of selected Schatzker I-III types of proximal tibial fractures.

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“…24,25 Functional results are rated as excellent or good in 90% of patients with a low rate of severe complications, despite one post-operative compartment syndrome being reported. 24 Using our preferred technique (percutaneous, arthroscopically-assisted or open technique) we must ensure the goal of the surgery: to obtain anatomical reduction and a fracture fixation stable enough to allow early/immediate knee motion.…”

Section: What Are the Indications For Surgical Treatment?mentioning

confidence: 99%

Treatment strategy for tibial plateau fractures: an update

2016

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Tibial plateau fractures are complex injuries produced by high- or low-energy trauma. They principally affect young adults or the ‘third age’ population.These fractures usually have associated soft-tissue lesions that will affect their treatment. Sequential (staged) treatment (external fixation followed by definitive osteosynthesis) is recommended in more complex fracture patterns. But one should remember that any type of tibial plateau fracture can present with soft-tissue complications.Typically the Schatzker or AO/OTA classification is used, but the concept of the proximal tibia as a three-column structure and the detailed study of the posteromedial and posterolateral fragment morphology has changed its treatment strategy.Limb alignment and articular surface restoration, allowing early knee motion, are the main goals of surgical treatment. Partially articular factures can be treated by minimally-invasive methods and arthroscopy is useful to assist and control the fracture reduction and to treat intra-articular soft-tissue injuries.Open reduction and internal fixation (ORIF) is the gold standard treatment for these fractures. Complex articular fractures can be treated by ring external fixators and minimally-invasive osteosynthesis (EFMO) or by ORIF. EFMO can be related to suboptimal articular reduction; however, outcome analysis shows results that are equal to, or even superior to, ORIF. The ORIF strategy should also include the optimal reduction of the articular surface.Anterolateral and anteromedial surgical approaches do not permit adequate reduction and fixation of posterolateral and posteromedial fragments. To achieve this, it is necessary to reduce and fix them through specific posterolateral or posteromedial approaches that allow optimal reduction and plate/screw placement.Some authors have also suggested that primary total knee arthroplasty could be an option in specific patients and with specific fracture patterns.Cite this article: Prat-Fabregat S, Camacho-Carrasco P. Treatment strategy for tibial plateau fractures: an update. EFORT Open Rev 2016;1:225-232. DOI: 10.1302/2058-5241.1.000031.

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Repair of Meniscal Tears Associated With Tibial Plateau Fractures

Abstract: Meniscal repair of tears associated with tibial plateau fractures has good results. All patients had good or excellent clinical results. Second-look arthroscopy confirmed complete healing in 92% of meniscal tears when performed.

Cited by 48 publications

References 41 publications

Outcomes and second-look arthroscopic evaluation after combined arthroscopic treatment of tibial plateau and tibial eminence avulsion fractures: a 5-year minimal follow-up

Outcomes and second-look arthroscopic evaluation after combined arthroscopic treatment of tibial plateau and tibial eminence avulsion fractures: a 5-year minimal follow-up

Arthroscopic management of proximal tibial fractures: technical note and case series presentation

Treatment strategy for tibial plateau fractures: an update

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