Arthroscopically-assisted Reduction and Internal Fixation (ARIF) of tibial plateau fractures: clinical and radiographic medium-term follow-up

Main Article Content

Massimiliano Leigheb
Mattia Rusconi
Antonio De Consoli
Massimiliano Fredo
Lia Rimondini
Andrea Cochis
Francesco Pogliacomi
Federico Alberto Grassi

Keywords

tibial plateau fractures, arthroscopy, internal fixation, joint trauma, post-traumatic osteoarthritis

Abstract

Background and Aim of the work: Tibial plateau fractures include a wide spectrum of lesions with
potentially disabling sequelae. Arthroscopically-assisted Reduction and Internal Fixation (ARIF) is an alternative
to traditional ORIF. The aim of this retrospective single centre study is to evaluate medium-term clinical and
radiographic outcomes achieved in a consecutive series of patients treated with ARIF. Methods: 21 patients, with a mean age of 52.2 ± 13.4 years at surgery, were included. According to Schatzker classification, there were 9 type II, 10 type III, 2 type IV fractures. Associated intra-articular injuries (meniscal tears, tibial spine fractures, chondral lesions) were detected in 8 patients. At follow up, patients were clinically and radiographically evaluated according to knee ROM, KOOS, OKS and Rasmussen Clinical and Radiological Scores. Results: At an average follow-up of 84 ± 22.5 months, 18 patients were evaluated. Mean values recorded were the following: knee ROM 1° - 135°, OKS 41.6 / 48 ± 8.18, subscale KOOS scores ranged from 75% ± 25.4 (Quality of Life) to 91.1% ± 11.2 (Pain), Rasmussen Clinical e Radiological 27.2 ± 2.64 (14 excellent, 3 good, 1 fair) and 9.1 ± 0.64 (15 excellent, 3 good) respectively. Worse results were observed in 5 patients with pre-existing degenerative chondropathy. Conclusions: ARIF revealed to be an effective technique for surgical treatment of unicondylar tibial plateau fractures. Our findings support the favourable results reported by other authors. ARIF is not a simple technique and requiresspecific experience in knee arthroscopy and a steep learning curve.(www.actabiomedica.it)

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