Department of Health Sciences, University of East Piedmont, Novara, Italy; Orthopaedics and Traumatology Unit, "Maggiore della Carità." Hospital, Novara, Italy.
Department of Health Sciences, University of East Piedmont, Novara, Italy.
Acta Biomed. 2020 May 30;91(4-S):152-159. doi: 10.23750/abm.v91i4-S.9500.
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.
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.
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.
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).
胫骨平台骨折包括广泛的损伤范围，可能导致致残性后遗症。关节镜辅助复位内固定（ARIF）是传统切开复位内固定（ORIF）的替代方法。本回顾性单中心研究的目的是评估连续系列接受 ARIF 治疗的患者的中期临床和放射学结果。
纳入 21 例患者，手术时平均年龄为 52.2 ± 13.4 岁。根据 Schatzker 分类，有 9 例 II 型，10 例 III 型，2 例 IV 型骨折。8 例患者合并关节内损伤（半月板撕裂、胫骨棘骨折、软骨损伤）。随访时，根据膝关节活动度、KOOS、OKS 和 Rasmussen 临床和放射学评分对患者进行临床和放射学评估。
平均随访 84 ± 22.5 个月，18 例患者接受评估。记录的平均数值如下：膝关节活动度 1°-135°，OKS 41.6/48 ± 8.18，KOOS 亚量表评分范围为 75%±25.4（生活质量）至 91.1%±11.2（疼痛），Rasmussen 临床和放射学评分分别为 27.2 ± 2.64（14 例优秀，3 例良好，1 例尚可）和 9.1 ± 0.64（15 例优秀，3 例良好）。5 例存在退行性软骨病的患者结果较差。
ARIF 被证明是治疗单髁胫骨平台骨折的有效手术技术。我们的发现支持了其他作者报告的良好结果。ARIF 不是一种简单的技术，需要在膝关节镜检查方面具有特定经验和陡峭的学习曲线。
