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磁共振成像证实的软组织损伤的存在对胫骨外侧平台骨折后12个月患者报告的结果没有显著影响:一项对56例患者的12个月前瞻性队列研究。

Presence of magnetic resonance imaging verified soft tissue injuries did not significantly affect the patient-reported outcome 12 months following a lateral tibial plateau fracture: A 12-month prospective cohort study of 56 patients.

作者信息

Elsoe Rasmus, Motahar Isa, Mahdi Firaz, Larsen Peter

机构信息

Department of Orthopaedic Surgery, Aalborg University Hospital, Hobrovej 18, 9000 Aalborg, Denmark.

Department of Radiology, Aalborg University Hospital, Hobrovej 18, 9000 Aalborg, Denmark.

出版信息

Knee. 2020 Mar;27(2):420-427. doi: 10.1016/j.knee.2020.01.008. Epub 2020 Feb 5.

Abstract

BACKGROUND

Soft tissue injuries following lateral tibial plateau fracture affect more than half of patients. Regardless of the type of soft tissue injured, it is still unclear how different treatment strategies influence postoperative outcome. The aim of this study was to report the 12-month Knee Injury and Osteoarthritis Outcome Score (KOOS) of patients with surgically managed lateral tibial plateau fractures divided into groups with and without conservatively managed magnetic resonance imaging (MRI)-verified soft tissue injuries.

METHODS

Prospective cohort study. Patients treated surgically following a lateral tibial plateau fracture (AO-41B) between December 2013 and November 2016 were included. Soft tissue injuries were evaluated with preoperative MRI scans. The primary outcome score was the 12-month KOOS score divided into groups with and without soft tissue injuries.

RESULTS

A total of 56 patients were included. Average patient age was 56 years (range 22-86). Thirty-three patients (59%) were female. Fifty percent of patients presented with MRI-verified soft tissue injuries. At 12 months postoperatively, the mean KOOS score for patients with soft tissue injuries was 53.5 (95% confidence interval (CI): 44.8-62.1) and the KOOS score for patients without soft tissue injuries was 59.6 (95% CI: 50.7-68.6). No significant difference in the KOOS score between patients with and without soft tissue injuries was observed (P = .31).

CONCLUSIONS

At 12-month follow-up the presence of MRI-verified soft tissue injuries did not significantly affect the patient-reported KOOS score. More research is needed to investigate the effects of surgical vs. non-surgical treatment strategies of associated soft tissue injuries following lateral tibial plateau fractures.

摘要

背景

胫骨外侧平台骨折后的软组织损伤影响超过半数的患者。无论软组织损伤的类型如何,不同的治疗策略如何影响术后结果仍不清楚。本研究的目的是报告接受手术治疗的胫骨外侧平台骨折患者的12个月膝关节损伤和骨关节炎疗效评分(KOOS),这些患者被分为有和没有经保守治疗的磁共振成像(MRI)证实的软组织损伤两组。

方法

前瞻性队列研究。纳入2013年12月至2016年11月期间接受胫骨外侧平台骨折(AO-41B)手术治疗的患者。术前通过MRI扫描评估软组织损伤情况。主要疗效评分为12个月的KOOS评分,分为有软组织损伤组和无软组织损伤组。

结果

共纳入56例患者。患者平均年龄为56岁(范围22 - 86岁)。33例(59%)为女性。50%的患者存在MRI证实的软组织损伤。术后12个月,有软组织损伤患者的平均KOOS评分为53.5(95%置信区间(CI):44.8 - 62.1),无软组织损伤患者的KOOS评分为59.6(95%CI:50.7 - 68.6)。有软组织损伤和无软组织损伤患者的KOOS评分无显著差异(P = 0.31)。

结论

在12个月的随访中,MRI证实的软组织损伤的存在并未显著影响患者报告的KOOS评分。需要更多研究来调查胫骨外侧平台骨折后相关软组织损伤的手术与非手术治疗策略的效果。

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