Meghan Maseda1, Sanjit Konda1,2, Philipp Leucht1, Abishek Ganta1,2, Raj Karia1, Kenneth Egol3,4. 1. Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, 301 E 17th Street, New York, NY, 10003, USA. 2. Department of Orthopedic Surgery, Jamaica Hospital Medical Center, New York, NY, USA. 3. Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, 301 E 17th Street, New York, NY, 10003, USA. Kenneth.Egol@nyulangone.org. 4. Department of Orthopedic Surgery, Jamaica Hospital Medical Center, New York, NY, USA. Kenneth.Egol@nyulangone.org.
Abstract
BACKGROUND: The purpose of this study was to compare outcomes following surgical treatment of tibial plateau fractures in an elderly (≥ 65y) and non-elderly (< 65) population. METHODS: Patients with tibial plateau fractures were prospectively followed. Patients were included if they were operatively treated, had an Injury Severity Score of < 16, and had follow-up through 12 months. Clinical, radiographic, and functional outcomes were evaluated at the 3, 6, and 12-month follow-up points. RESULTS: Mean time to radiographic fracture union was by 4.68 and 5.26 months in young and elderly patients, respectively (p = 0.25). There was no difference in self-reported baseline SMFA (p = 0.617). SMFA scores were better in younger patients at 3 months (p = 0.031), however this did not hold when multivariate modeling controlled for other factors. There was no difference at 6 and 12 months (p = 0.475, 0.392). There was no difference in range of knee motion at 3 months. At 6 and 12 months, young patients had statistically but not clinically better range of knee motion (p = 0.045, 0.007). There were no differences in overall reoperation rates, conversion arthroplasty, post-traumatic osteoarthritis or wound complications. CONCLUSIONS: Age greater than 65 does not appear to portend poorer outcomes after surgical repair of a tibial plateau fracture. The complication profiles are similar. Elderly and younger patients had similar function at 12 months compared to their baseline. These data suggest that age should not be a disqualifying factor when considering whether a patient with a tibial plateau fracture should be treated operatively.
BACKGROUND: The purpose of this study was to compare outcomes following surgical treatment of tibial plateau fractures in an elderly (≥ 65y) and non-elderly (< 65) population. METHODS: Patients with tibial plateau fractures were prospectively followed. Patients were included if they were operatively treated, had an Injury Severity Score of < 16, and had follow-up through 12 months. Clinical, radiographic, and functional outcomes were evaluated at the 3, 6, and 12-month follow-up points. RESULTS: Mean time to radiographic fracture union was by 4.68 and 5.26 months in young and elderly patients, respectively (p = 0.25). There was no difference in self-reported baseline SMFA (p = 0.617). SMFA scores were better in younger patients at 3 months (p = 0.031), however this did not hold when multivariate modeling controlled for other factors. There was no difference at 6 and 12 months (p = 0.475, 0.392). There was no difference in range of knee motion at 3 months. At 6 and 12 months, young patients had statistically but not clinically better range of knee motion (p = 0.045, 0.007). There were no differences in overall reoperation rates, conversion arthroplasty, post-traumatic osteoarthritis or wound complications. CONCLUSIONS: Age greater than 65 does not appear to portend poorer outcomes after surgical repair of a tibial plateau fracture. The complication profiles are similar. Elderly and younger patients had similar function at 12 months compared to their baseline. These data suggest that age should not be a disqualifying factor when considering whether a patient with a tibial plateau fracture should be treated operatively.
Authors: Elizabeth Gausden; Matthew R Garner; Peter D Fabricant; Stephen J Warner; Andre D Shaffer; Dean G Lorich Journal: Arch Orthop Trauma Surg Date: 2017-04-08 Impact factor: 3.067
Authors: Kenneth A Egol; Nirmal C Tejwani; Michael G Walsh; Edward L Capla; Kenneth J Koval Journal: J Bone Joint Surg Am Date: 2006-05 Impact factor: 5.284