Main Article Content
tibial plateau fractures, treatment, arthroscopy, surgery, artrhoscopic-assisted
The purpose of this study was to describe the authors’ arthroscopic-assisted reduction and fixation (ARIF) technique in the treatment of type Schatzker I-III tibial plateau fractures, with the use of instruments commonly used in anterior cruciate ligament reconstruction, evaluating clinical and radiological outcomes on four patients at short-term follow-up.
A retrospective analysis was performed in our Institution considering 4 patients who underwent ARIF procedure between 2018 and 2020 at minimum 3 months of follow-up. All patients were evaluated clinically (Rasmussen Score, VAS and Crosby-Insall Grading) and radiographically (after surgery and at 6 weeks).
Mean follow-up was 9 months (range 6-12 months). Rasmussen score and VAS were respectively 26 (Excellent) and 1 at the last follow-up. According to the Crosby-Insall Grading System, all patients reported excellent results.
At final control the mean ROM in the injured knee was 125°(range 100°-140°). Mean hospitalization was 2 days (range 1-4 days). No adverse events were reported.
ARIF is a reliable technique for tibial plateau fracture (Schatzker I-III). The technique described is very cheap and reproducible in any hospital . This procedure allows to well understand the pattern of fracture and to obtain an anatomical reduction with a great tissue sparing and a faster recovery of knee function.
Level of Evidence: Level IV
Keywords: tibial plateau fractures, treatment, arthroscopy, surgery, artrhoscopic-assisted
2. Schatzker J, McBroom R, Bruce D. The tibial plateau fracture: the Toronto experience: 1968–1975. Clin Or-thop Relat Res 1979;138:94–104
3. Rademakers MV, Kerkhoffs GM, Sierevelt IN, Raaymakers EL, Marti RK. Operative treatment of 109 tibial plateau fractures: five- to 27-year follow-up results. J Orthop Trauma 2007;21:5-10.
4. Chase R, Usmani K, Shahi A, Graf K, Mashru R. Arthroscopic-Assisted Reduction of Tibial Plateau Frac-tures. Orthop Clin North Am. 2019 Jul;50(3):305-314. Review.
5. Lubowitz JH, Elson WS, Guttmann D, et al. Part I arthroscopic management of tibial plateau fractures. Ar-throscopy 2004;20:1063–70.
6. Rossi R, Castoldi F, Blonna D, Marmotti A, Assom M. Arthroscopic treatment of lateral tibial plateau frac-tures: a simple technique. Arthroscopy. 2006;22:678.e1–6..
7. Burdin G. Arthroscopic management of tibial plateau fractures: Surgical technique. Orthop Traumatol Surg Res 2013;99S:S208–18.
8. David E. Hartigan, Mark A. McCarthy, Aaron J. Krych, Bruce A. Levy Arthroscopic-Assisted Reduction and Percutaneous Fixation of Tibial Plateau Fractures. Arthrosc Tech. 2015 Feb; 4(1): e51–e55
9. Hofmann A, Gorbulev S, Guehring T et al. Autologous Iliac Bone Graft Compared With Biphasic Hydroxy-apatite and Calcium Sulfate Cement for the Treatment of Bone Defects in Tibial Plateau Fractures: A Pro-spective, Randomized, Open-Label, Multicenter Study. J Bone Joint Surg Am 2020 Feb 5;102(3):179-193
10. Ozkut AT, Poyanli OS, Ercin E, Akan K, Esenkaya I. Arthroscopic Technique for Treatment of Schatzker Type III Tibia Plateau Fractures Without Fluoroscopy. Arthrosc Tech. 2017 Feb; 6(1): e195–e199.
11. Berkes MB, Little MT, Schottel PC et al. Outcomes of Schatzker II Tibial Plateau Fracture Open Reduction Internal Fixation Using Structural Bone Allograft. J Orthop Trauma. 2014 Feb;28(2):97-102
12. Iundusi R, Gasbarra E, D’Arienzo M, Piccioli A, Tarantino U. Augmentation of tibial plateau fractures with an injectable bone substitute: CERAMENT™. Three year follow-up from a prospective study. BMC Muscu-loskelet Disord. 2015; 16: 115.
13. Hong-Wei Chen , Qing Bi , Li-Jun Wu. Risk factors of traumatic knee osteoarthritis after arthroscopic sur-gery treated tibial plateau fractures. Int J Clin Exp Med 2017;10(5):8192-8199
14. Zawam S.H.M., Gad A.M. Arthroscopic Assisted Reduction and Internal Fixation of Tibial Plateau Fractures. Open Access Maced J Med Sci. 2019 Apr 15; 7(7): 1133–1137.