Department for Orthopedic Sports Medicine, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany.
Department of Orthopedics and Trauma Surgery, Medical Center, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg, Germany.
Arch Orthop Trauma Surg. 2022 Dec;142(12):3623-3631. doi: 10.1007/s00402-021-03961-6. Epub 2021 May 19.
To investigate functional and clinical outcomes, and physical activity after arthroscopic suture fixation of tibial eminence fractures with regard to postoperative stability, range of motion (ROM), complications, and return to sports.
Patients undergoing arthroscopic reduction and internal fixation (ARIF) of tibial eminence fractures using a suture fixation technique were included. Outcome was evaluated retrospectively after a minimum follow-up of 24 months using KT-1000 arthrometer measurements, clinical examination, outcome scores (Lysholm score, Tegner Activity Scale), and a questionnaire about sport activities.
A total of 23 patients (44% male, 57% female) with a mean age of 25 ± 15 years were included. Mean follow-up was 57 ± 25 months. KT-1000 arthrometer measurements of anterior tibial translation revealed a mean side-to-side difference of 0.9 ± 1.0 mm. Clinical examination showed 100% normal or nearly normal anterior translation of the tibia. Two patients (9%) received an ACL reconstruction due to traumatic ACL re-instability and were, therefore, considered as failures. An extension deficit concerning hyperextension occurred in 29% of patients postoperatively. Further postoperative complications occurred in 14% of patients and included postoperative stiffness with ROM limitations and secondary dislocation of a fragment. Mean postoperative Lysholm score was 89 ± 14. Comparing pre- and postoperative values, no significant change of the Tegner Activity Scale was observed. All patients (failures excluded) returned to high impact sports activities after ARIF.
Excellent reliable ligamentous stability and high rates of return to high impact sports can be expected after ARIF using a suture fixation technique for type II-IV tibial eminence fractures. Complications, such as limitations in ROM, commonly occur in up to 30% after ARIF. Therefore, regular follow-up examinations remain important in this usually young patient cohort.
Level IV.
研究关节镜下胫骨髁间隆突骨折采用缝线固定后功能和临床结果，以及运动活动度，同时评估术后稳定性、活动范围（ROM）、并发症和重返运动情况。
纳入采用缝线固定技术行关节镜下复位内固定（ARIF）治疗胫骨髁间隆突骨折的患者。至少随访 24 个月后，通过 KT-1000 关节测量仪测量、临床检查、结果评分（Lysholm 评分、Tegner 活动量表）和关于运动活动的问卷调查进行回顾性评估。
共纳入 23 例患者（44%为男性，57%为女性），平均年龄为 25±15 岁。平均随访时间为 57±25 个月。KT-1000 关节测量仪测量胫骨前向平移，平均侧别差值为 0.9±1.0mm。临床检查显示 100%的胫骨前向平移正常或接近正常。2 例患者（9%）因创伤性前交叉韧带再不稳定而行 ACL 重建，因此视为失败病例。术后有 29%的患者出现过伸过度的伸展缺陷。另外 14%的患者出现了术后并发症，包括 ROM 受限的术后僵硬和骨折块的二次脱位。术后 Lysholm 评分为 89±14。与术前相比，Tegner 活动量表的评分无明显变化。所有患者（失败病例除外）在 ARIF 后均恢复到高冲击运动。
采用缝线固定技术治疗 II-IV 型胫骨髁间隆突骨折，可获得可靠的韧带稳定性，术后高冲击运动的恢复率高。ARIF 后，ROM 受限等并发症常在 30%左右发生。因此，在这一通常为年轻患者的队列中，定期的随访检查仍然很重要。
IV 级。
