Seong Hwan Kim1,2, Seung Hyuk Lee3, Hyungon Gwak3, Kang Ii Kim3, Sang Hak Lee4. 1. Department of Orthopedic Surgery, Chung-Ang University Hospital, 102, Heukseok-ro, Dongjak-gu, Seoul, South Korea. 2. Department of Orthopedic Surgery, Hyundae General Hospital, Chung-Ang University College of Medicine, 21, Bonghyeon-ro, Jinjeop-eup, Namyangju-si, Gyeonggi-do, 12013, South Korea. 3. Center for Joint Diseases and Rheumatism, Kyung Hee University Hospital at Gangdong, 892 Dongnam-ro, Gangdong-gu, Seoul, 134-727, South Korea. 4. Center for Joint Diseases and Rheumatism, Kyung Hee University Hospital at Gangdong, 892 Dongnam-ro, Gangdong-gu, Seoul, 134-727, South Korea. sangdory@hanmail.net.
Abstract
INTRODUCTION: To evaluate the clinical and radiographic results of AR/IF and meniscus repair for treating lateral meniscus (LM) tears associated with lateral tibial plateau fractures and to identify the factors associated with LM tear. MATERIALS AND METHODS: Forty-two patients with lateral plateau fractures (Schatzker types II and III) treated by AR/IF were included retrospectively. Radiographic evaluations using the Rasmussen system and computerized tomography (CT) were performed. Clinical evaluations were also conducted at final follow-up. Second-look arthroscopy was applied during metal removal. RESULTS: All fractures were healed after 46.3 months of follow-up. The mean Tegner activity level was not decreased significantly, going from 7.1 ± 2.1 pre-injury to 6.6 ± 2.3 at final follow-up (p = 0.301). However, the amount of depression noted on CT imaging was significantly decreased from 8.9 mm ± 4.4 to 1.2 mm ± 1.3 (p = 0.000). The mean Rasmussen radiologic score at final follow-up was 14.5 ± 5.3 points. Osteoarthritis was progressed in six patients (14.3%). Twenty-five patients had concomitant LM tear, with 18 cases treated by repair and the remaining ones treated by partial meniscectomy. Preoperative joint depression (> 11 mm) was significantly associated with the risk of LM tear (p = 0.024; odds ratio (OR): 9.0, 95% confidence interval (CI): 1.018-79.545) and most of those lesions could be repaired (p = 0.001). Postoperatively, 16 repaired patients were evaluated by second-look arthroscopy; 15 had healed completely and one had healed partially. CONCLUSION: LM tears are frequently combined with lateral tibial plateau fracture, especially in correlation with more than 11 mm of joint depression, though most of those lesions can be repaired at the time of fracture fixation. AR/IF with arthroscopic meniscus repair could achieve good clinical and radiographic outcomes when treating Schatzker types II and III tibial plateau fractures. STUDY DESIGN: Level IV retrospective cohort study.
INTRODUCTION: To evaluate the clinical and radiographic results of AR/IF and meniscus repair for treating lateral meniscus (LM) tears associated with lateral tibial plateau fractures and to identify the factors associated with LM tear. MATERIALS AND METHODS: Forty-two patients with lateral plateau fractures (Schatzker types II and III) treated by AR/IF were included retrospectively. Radiographic evaluations using the Rasmussen system and computerized tomography (CT) were performed. Clinical evaluations were also conducted at final follow-up. Second-look arthroscopy was applied during metal removal. RESULTS: All fractures were healed after 46.3 months of follow-up. The mean Tegner activity level was not decreased significantly, going from 7.1 ± 2.1 pre-injury to 6.6 ± 2.3 at final follow-up (p = 0.301). However, the amount of depression noted on CT imaging was significantly decreased from 8.9 mm ± 4.4 to 1.2 mm ± 1.3 (p = 0.000). The mean Rasmussen radiologic score at final follow-up was 14.5 ± 5.3 points. Osteoarthritis was progressed in six patients (14.3%). Twenty-five patients had concomitant LM tear, with 18 cases treated by repair and the remaining ones treated by partial meniscectomy. Preoperative joint depression (> 11 mm) was significantly associated with the risk of LM tear (p = 0.024; odds ratio (OR): 9.0, 95% confidence interval (CI): 1.018-79.545) and most of those lesions could be repaired (p = 0.001). Postoperatively, 16 repaired patients were evaluated by second-look arthroscopy; 15 had healed completely and one had healed partially. CONCLUSION: LM tears are frequently combined with lateral tibial plateau fracture, especially in correlation with more than 11 mm of joint depression, though most of those lesions can be repaired at the time of fracture fixation. AR/IF with arthroscopic meniscus repair could achieve good clinical and radiographic outcomes when treating Schatzker types II and III tibial plateau fractures. STUDY DESIGN: Level IV retrospective cohort study.
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