Patricia M Lutz1, Stephanie Geyer2, Philipp W Winkler2, Markus Irger2, Daniel P Berthold2, Matthias J Feucht2,3, Andreas B Imhoff2, Philipp Forkel2. 1. Department for Orthopedic Sports Medicine, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany. patricia.lutz@gmx.net. 2. Department for Orthopedic Sports Medicine, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany. 3. Department of Orthopedics and Trauma Surgery, Medical Center, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg, Germany.
Abstract
PURPOSE: To investigate functional and clinical outcomes, and physical activity after arthroscopic suture fixation of tibial eminence fractures with regard to postoperative stability, range of motion (ROM), complications, and return to sports. METHODS: Patients undergoing arthroscopic reduction and internal fixation (ARIF) of tibial eminence fractures using a suture fixation technique were included. Outcome was evaluated retrospectively after a minimum follow-up of 24 months using KT-1000 arthrometer measurements, clinical examination, outcome scores (Lysholm score, Tegner Activity Scale), and a questionnaire about sport activities. RESULTS: A total of 23 patients (44% male, 57% female) with a mean age of 25 ± 15 years were included. Mean follow-up was 57 ± 25 months. KT-1000 arthrometer measurements of anterior tibial translation revealed a mean side-to-side difference of 0.9 ± 1.0 mm. Clinical examination showed 100% normal or nearly normal anterior translation of the tibia. Two patients (9%) received an ACL reconstruction due to traumatic ACL re-instability and were, therefore, considered as failures. An extension deficit concerning hyperextension occurred in 29% of patients postoperatively. Further postoperative complications occurred in 14% of patients and included postoperative stiffness with ROM limitations and secondary dislocation of a fragment. Mean postoperative Lysholm score was 89 ± 14. Comparing pre- and postoperative values, no significant change of the Tegner Activity Scale was observed. All patients (failures excluded) returned to high impact sports activities after ARIF. CONCLUSION: Excellent reliable ligamentous stability and high rates of return to high impact sports can be expected after ARIF using a suture fixation technique for type II-IV tibial eminence fractures. Complications, such as limitations in ROM, commonly occur in up to 30% after ARIF. Therefore, regular follow-up examinations remain important in this usually young patient cohort. LEVEL OF EVIDENCE: Level IV.
PURPOSE: To investigate functional and clinical outcomes, and physical activity after arthroscopic suture fixation of tibial eminence fractures with regard to postoperative stability, range of motion (ROM), complications, and return to sports. METHODS:Patients undergoing arthroscopic reduction and internal fixation (ARIF) of tibial eminence fractures using a suture fixation technique were included. Outcome was evaluated retrospectively after a minimum follow-up of 24 months using KT-1000 arthrometer measurements, clinical examination, outcome scores (Lysholm score, Tegner Activity Scale), and a questionnaire about sport activities. RESULTS: A total of 23 patients (44% male, 57% female) with a mean age of 25 ± 15 years were included. Mean follow-up was 57 ± 25 months. KT-1000 arthrometer measurements of anterior tibial translation revealed a mean side-to-side difference of 0.9 ± 1.0 mm. Clinical examination showed 100% normal or nearly normal anterior translation of the tibia. Two patients (9%) received an ACL reconstruction due to traumatic ACL re-instability and were, therefore, considered as failures. An extension deficit concerning hyperextension occurred in 29% of patients postoperatively. Further postoperative complications occurred in 14% of patients and included postoperative stiffness with ROM limitations and secondary dislocation of a fragment. Mean postoperative Lysholm score was 89 ± 14. Comparing pre- and postoperative values, no significant change of the Tegner Activity Scale was observed. All patients (failures excluded) returned to high impact sports activities after ARIF. CONCLUSION: Excellent reliable ligamentous stability and high rates of return to high impact sports can be expected after ARIF using a suture fixation technique for type II-IV tibial eminence fractures. Complications, such as limitations in ROM, commonly occur in up to 30% after ARIF. Therefore, regular follow-up examinations remain important in this usually young patient cohort. LEVEL OF EVIDENCE: Level IV.
Authors: Tran Trung Dung; Hoang Gia Du; Nguyen Hoang Long; Le Manh Son; Dao Xuan Thanh; Dinh Ngoc Son; Nguyen Trung Tuyen; Do Van Minh; Nguyen Huy Phương; Vu Tu Nam; Pham Trung Hieu; Ma Ngoc Thanh Journal: Eur J Orthop Surg Traumatol Date: 2019-06-24
Authors: Andrea Achtnich; Elmar Herbst; Philipp Forkel; Sebastian Metzlaff; Frederike Sprenker; Andreas B Imhoff; Wolf Petersen Journal: Arthroscopy Date: 2016-06-17 Impact factor: 4.772
Authors: Matthias J Feucht; Peter U Brucker; Carlo Camathias; Karl-Heinz Frosch; Michael T Hirschmann; Stephan Lorenz; Hermann O Mayr; Philipp Minzlaff; Wolf Petersen; Tim Saier; Dorien Schneidmüller; Amelie Stoehr; Daniel Wagner; Norbert P Südkamp; Philipp Niemeyer Journal: Knee Surg Sports Traumatol Arthrosc Date: 2016-05-27 Impact factor: 4.342
Authors: Joshua T Bram; Lacey C Magee; Nishank N Mehta; Neeraj M Patel; Theodore J Ganley Journal: Am J Sports Med Date: 2020-10-22 Impact factor: 6.202
Authors: Mark Callanan; Judd Allen; Brett Flutie; Francis Tepolt; Patricia E Miller; Dennis Kramer; Mininder S Kocher Journal: Orthop J Sports Med Date: 2019-11-22