Outcomes and second-look arthroscopic evaluation after combined arthroscopic treatment of tibial plateau and tibial eminence avulsion fractures: a 5-year minimal follow-up.
BACKGROUND
Tibial eminence avulsion fracture often co-occurs with tibial plateau fracture, which leads to difficult concomitant management. The value of simultaneous arthroscopy-assisted treatment continues to be debated despite its theoretical advantages. We describe a simple arthroscopic suture fixation technique and hypothesize that simultaneous treatment is beneficial.


METHODS
Patients with a tibial eminence avulsion fracture and a concurrent tibial plateau fracture who underwent simultaneous arthroscopically assisted treatment between 2005 and 2008 were enrolled in this retrospective study. Second-look arthroscopic evaluation and Rasmussen scores of clinical and radiographic parameters were used to assess simultaneous treatment.


RESULTS
Forty-one patients (41 knees) met the inclusion criteria. All 41 fractures were successfully united. All patients had side-to-side differences of less than 3 mm and negative findings in Lachman and pivot-shift tests at their final follow-up. The mean postoperative Rasmussen clinical score was 27.3 (range: 19-30), and the mean radiologic score was 16.5 (range: 12-18). Clinical and radiographic outcomes in 98 % of the patients were good or excellent. There were no complications directly associated with arthroscopy in any patient.


CONCLUSIONS
Simultaneous arthroscopic suture fixation of associated tibial eminence avulsion fracture did not interfere with the plates and screws used to stabilize the tibial plateau fracture. It gave the knee joint adequate stability, minimal surgical morbidity, and satisfactory radiographic and clinical outcomes in a minimum follow-up of 5 years and in the arthroscopic second-look assessments.
Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan. b8601081@adm.cgmh.org.tw.|Chang Gung University, Taoyuan, Taiwan. b8601081@adm.cgmh.org.tw.
Tsan-Wen
TW
Huang
Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan. chienyin@gmail.com.
Chien-Ying
CY
Lee
Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan. b9002035@adm.cgmh.org.tw.
Szu-Yuan
SY
Chen
Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan. b9002092@adm.cgmh.org.tw.
Shih-Jie
SJ
Lin
Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan. emsequoia@cgmh.org.tw.|Chang Gung University, Taoyuan, Taiwan. emsequoia@cgmh.org.tw.
Kuo-Yao
KY
Hsu
Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan. wwh@adm.cgmh.org.tw.|Chang Gung University, Taoyuan, Taiwan. wwh@adm.cgmh.org.tw.
Robert Wen-Wei
RW
Hsu
Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan. chan512@adm.cgmh.org.tw.|Chang Gung University, Taoyuan, Taiwan. chan512@adm.cgmh.org.tw.
Yi-Sheng
YS
Chan
Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan. mellee@cgmh.org.tw.|Chang Gung University, Taoyuan, Taiwan. mellee@cgmh.org.tw.
Mel S
MS
Lee
D000328:Adult; D001182:Arthroscopy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D024162:Second-Look Surgery; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult