Juriaan Van den Berg1, Maike Reul2, Olivier Vinckier1, Robert Jan Derksen3, Stefaan Nijs1,4, Michiel Verhofstad5, Harm Hoekstra6,7. 1. Department of Trauma Surgery, University Hospitals Leuven, Leuven, Belgium. 2. Department of Orthopedics and Traumatology, VU Brussel-Free University of Brussels, Brussels, Belgium. 3. Department of Surgery, Zaans Medical Center, Zaandam, The Netherlands. 4. Department of Development and Regeneration, KU Leuven-University of Leuven, Leuven, Belgium. 5. Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands. 6. Department of Trauma Surgery, University Hospitals Leuven, Leuven, Belgium. harm.hoekstra@uzleuven.be. 7. Department of Development and Regeneration, KU Leuven-University of Leuven, Leuven, Belgium. harm.hoekstra@uzleuven.be.
Abstract
INTRODUCTION: Operative management of posterior tibial plateau fractures (PTPF) remains challenging. The treatment goal is to restore the alignment and articular congruence, and providing sufficient stability which allows early mobilization. The purpose of this study was to assess the feasibility and safety of the newly developed WAVE posterior proximal tibia plate. METHODS: Between Oct 2017 and Jun 2020, 30 adult patients with a tibial plateau fracture and posterior involvement were selected for treatment with a WAVE posterior proximal tibia plate. Patient reported outcome was assessed using the Knee injury and Osteoarthritis Outcome Score (KOOS) at time of injury (pre-injury) and at 1-year follow-up. Radiological outcome was evaluated with CT-imaging. RESULTS: Twenty-eight patients were eligible for treatment with the new implant (3 'one-column', 10 'two column' and 15 'three-column' fractures), whereas in 2 patients anatomical fit was insufficient. KOOS results showed fair outcome scores at 1 year, with a large negative impact compared to pre-injury levels; however, a trend towards better results compared to a previous PTPF reference cohort. Radiological follow-up showed insufficient posterolateral buttress in two cases and residual articular step-off (> 2 mm) in seven patients, of which five were classified as three column fractures. CONCLUSION: Management of PTPF using the WAVE posterior proximal tibia plate is feasible and safe with satisfactory clinical and radiological results after 1 year. Nevertheless, there is a learning curve regarding optimal implant positioning to achieve the maximum benefit of the implant.
INTRODUCTION: Operative management of posterior tibial plateau fractures (PTPF) remains challenging. The treatment goal is to restore the alignment and articular congruence, and providing sufficient stability which allows early mobilization. The purpose of this study was to assess the feasibility and safety of the newly developed WAVE posterior proximal tibia plate. METHODS: Between Oct 2017 and Jun 2020, 30 adult patients with a tibial plateau fracture and posterior involvement were selected for treatment with a WAVE posterior proximal tibia plate. Patient reported outcome was assessed using the Knee injury and Osteoarthritis Outcome Score (KOOS) at time of injury (pre-injury) and at 1-year follow-up. Radiological outcome was evaluated with CT-imaging. RESULTS: Twenty-eight patients were eligible for treatment with the new implant (3 'one-column', 10 'two column' and 15 'three-column' fractures), whereas in 2 patients anatomical fit was insufficient. KOOS results showed fair outcome scores at 1 year, with a large negative impact compared to pre-injury levels; however, a trend towards better results compared to a previous PTPF reference cohort. Radiological follow-up showed insufficient posterolateral buttress in two cases and residual articular step-off (> 2 mm) in seven patients, of which five were classified as three column fractures. CONCLUSION: Management of PTPF using the WAVE posterior proximal tibia plate is feasible and safe with satisfactory clinical and radiological results after 1 year. Nevertheless, there is a learning curve regarding optimal implant positioning to achieve the maximum benefit of the implant.
Authors: Sarah N Pierrie; Luke S Harmer; Madhav A Karunakar; Marc R Angerame; Erica B Andrews; Katherine M Sample; Joseph R Hsu Journal: J Knee Surg Date: 2015-11-09 Impact factor: 2.757
Authors: Wenwen Mao; Gang Chen; Yousen Zhu; Min Zhang; Jiangying Ru; Jinguang Wang; Li Li Journal: Medicine (Baltimore) Date: 2021-09-24 Impact factor: 1.817