A midterm analysis of Tibial plateau fractures: functional outcome and incidence of osteoarthritis in 240 cases

  • Jati S Department of orthopedics, Sri Aurbindo Medical College, Indore, Madhya Pradesh, India
  • Champawat V. Department of orthopedics, Sri Aurbindo Medical College, Indore, Madhya Pradesh, India
Keywords: Tibial Plateau fracture, post-traumatic arthritis, Proximal tibia Fracture

Abstract

Background: Tibial plateau fractures are a risk to the functional integrity of the knee. They are the result of axial compressive forces alone or combined with Varus or valgus stress on the knee joint. Post-traumatic osteoarthritis occurs after traumatic injury to the joint. The presence of residual incongruity at the time of fracture healing could lead to joint stiffness and long-term morbidity, studies have established the restoration of articular congruity as the key principle on the management of these injuries. Despite anatomical joint reconstruction, development of osteoarthritis may still take place secondary to the initial articular cartilage injury. This prospective study evaluates the functional and radiological outcome of surgically managed tibial plateau fractures and incidence of osteoarthritis.

Methods: In this prospective study 240 patients with tibial plateau fractures managed by different modalities were included. Patients were evaluated by Rasmussen criteria clinically and radiologically by Kellgren & Lawrence grading for development of osteoarthritis at 6 weeks, 3 months, 6 months, 1 year and then subsequent follow-ups.

Results: Rasmussen clinical scoring system showed excellent results in around 34% (82) of the patients, 53% (127) had good,9% (22) fair and 4% (9) poor results. Out of 240 patients 78 (32.5%) developed OA knee (including Kellgren and Lawrence grade 1) which is a significant number of patients. With increase in schatzker type & amount of articular depression the number of patients developing Osteoarthritis increased, schatzker Type I -16 % vs schatzker Type VI - 54% and no articular depression 9.5% vs > 5mm articular depression 46 %.

Conclusion: With increase in schatzker type & amount of articular depression the chance of patient developing Osteoarthritis significantly increases and thus excellent anatomical reduction with restored articular congruity rigid fixation is required to facilitate early knee motion and reduces chances of post-traumatic osteoarthritis.

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References

Lansinger O, Bergman B, Korner L et al (1986) Tibial condylar fractures. A twenty-year follow-up. J Bone Joint Surg Am 68:13–19

Martin JA, Buckwalter JA. Post-traumatic osteoarthritis: the role of stress induced chondrocyte damage. Biorheology. 2006;43(3-4):517-521.

Bacon S, Smith WR, Morgan SJ, et al. A retrospective analysis of comminuted intra-articular fractures of the tibial plafond: open reduction and internal fixation versus external Ilizarov fixation. Injury 2008;39:196–202.

Stoop R. Smart biomaterials for tissue engineering of cartilage. Injury 2008;39(Suppl 1):S77–87.

Honkonen SE (1995) Degenerative arthritis after tibial plateau fractures. J Orthop Trauma 9:273–277

Marsh JL, Buckwalter J, Gelberman R et al (2002) Articular fractures: does an anatomic reduction really change the result? J Bone Joint Surg Am 84-A:1259–1271

Papagelopoulos PJ, Partsinevelos AA, Themistocleous GS et al (2006) Complications after tibia plateau fracture surgery. Injury37:475–484

Rasmussen PS (1973) Tibial condylar fractures. Impairment of knee joint stability as an indication for surgical treatment. J Bone Joint Surg Am 55:1331–1350

Rademakers MV, Kerkhoffs GM, Sierevelt IN, et al. Operative treatment of 109 tibial plateau fractures: five- to 27-year follow-up results. J Orthop Trauma 2007;21:5-10.
Published
2017-12-31
CITATION
DOI: 10.5281/zenodo.3970336
Published: 2017-12-31
How to Cite
1.
Jati S, Champawat V. A midterm analysis of Tibial plateau fractures: functional outcome and incidence of osteoarthritis in 240 cases. ojmpc [Internet]. 2017Dec.31 [cited 2024Mar.29];23(2):16-1. Available from: https://ojmpc.com/index.php/ojmpc/article/view/54
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Original Article