Second-look arthroscopy after surgical treatment of Schatzker type II plateau fractures through the lateral submeniscal approach.
OBJECTIVE
To evaluate cartilage healing using second-look arthroscopic examination in tibia plateau fracture patients who have undergone open reduction and internal fixation with a submeniscal approach technique.


METHODS
Between January 2007 and January 2010, we used second-look arthroscopy during 18-24-month follow-up of 20 patients with Schatzkar type II tibial plateau fractures who had undergone open reduction and internal fixation with a submeniscal approach technique. We classified patients according to step-off, knee range of motion, and Knee Society Score, and compared the results with those obtained by arthroscopy.


RESULTS
Radiologically, 16 cases (80 %) were reduced within 2 mm of step-off. In 11 of these cases, according to the Outerbridge classification, we checked for chondromalacia from grade II to III. We observed 2 mm of step-off in four cases, and each had chondromalacia of at least grade III. The Knee Society Score was associated with chondromalacia grade (p < 0.05).


CONCLUSIONS
Even in patients with normal joint range of motion and good clinical and radiological results, the actual condition of the articular cartilage varied significantly. Therefore, more long-term and regular follow-up is needed for proximal plateau fractures.
Department of Orthopaedic Surgery, Chung-Ang University, College of Medicine, Seoul, Korea.
Han-Jun
HJ
Lee
Ho-Joong
HJ
Jung
Eui-Chan
EC
Chang
Jae-Sung
JS
Lee
Hyoung-Seok
HS
Jung
D000328:Adult; D001182:Arthroscopy / Q000379:methods*; D002357:Cartilage Diseases / Q000473:pathology; D002358:Cartilage, Articular / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D024162:Second-Look Surgery / Q000379:methods*; D013978:Tibial Fractures / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult