Honkonen S E
Tampere University Hospital, Finland.
J Orthop Trauma. 1995;9(4):273-7. doi: 10.1097/00005131-199509040-00001.
Secondary osteoarthritis after tibial plateau fracture was found in 44% of 131 cases at 7.6 (3.3-13.4) years follow-up. Narrowing of the joint space was noted during the first 7 years after injury, usually in the same compartment as the fractured plateau. The incidence slightly increased with the age of patients. Removal of a meniscus during the fracture surgery resulted in secondary degeneration in 74% of the cases. When a meniscus was intact or repaired, the proportion of degenerative cases was only 37%. Normal or slight valgus alignment of the tibial plateau with intact menisci protected best against secondary degeneration. On the other hand, medial or lateral tilt of the tibial plateau with a removed meniscus was followed by osteoarthritis in most cases. The severity of articular irregularities correlated poorly with the degenerative process. Associated ligamentous injuries as well as postoperative infection increased the incidence of secondary degeneration.
在对131例患者进行7.6（3.3 - 13.4）年的随访中，发现胫骨平台骨折后继发性骨关节炎的发生率为44%。在受伤后的前7年观察到关节间隙变窄，通常发生在与骨折平台相同的关节腔。发病率随患者年龄略有增加。骨折手术中切除半月板的患者，74%会发生继发性退变。当半月板完整或修复时，退变病例的比例仅为37%。胫骨平台正常或轻度外翻且半月板完整，对预防继发性退变的保护作用最佳。另一方面，半月板切除后胫骨平台出现内翻或外翻倾斜，在大多数情况下会继发骨关节炎。关节面不平整的严重程度与退变过程的相关性较差。合并的韧带损伤以及术后感染会增加继发性退变的发生率。
