The Clinicoradiological Outcome of Arthroscopic-assisted Reduction and Internal Fixation of Tibial Plateau Fractures

Abstract

Abstract Background: The fractures of the tibial plateau are intraarticular fractures accounting for 1% of all fractures. Surgical management of such fractures is often challenging because they require anatomical reduction and stable fixation, which will allow for early rehabilitation. Arthroscopy has evolved nowadays and arthroscopically assisted reduction and fixation is a good option among the available surgical options. Materials and Methods: This prospective study included 50 cases of tibial plateau fractures managed surgically by arthroscopic-assisted reduction and fixation starting from August 2019 to December 2022. Results: The patients were 39 years old on average and were mostly men (58%). The right knee was the most usually injured (53%), and the most common cause of injury (41.5%) was a fall from a height. The majority of these fractures (44.5%) belonged to Schatzker type 2, followed by type 1 (37%) and type 3 (18.5%). The average time to complete weight-bearing for a Schatzker type I fracture was 10 weeks, 11.5 weeks for a type II fracture, and 13.5 weeks for a type III fracture. The average time to union for Schatzker type I was 13 weeks, 15.5 weeks for type II, and 16 weeks for type III. The mean clinical and radiological scores using the modified Rasmussen criteria were 26.3 and 7.3, respectively. Conclusions: A good surgical outcome of tibial plateau fracture is acquired when anatomic articular surface reconstruction with the elevation of depressed bone fragment is combined with rigid stable fixation, which permits early rehabilitation. Arthroscopy helps in achieving these goals by providing a good visualization of the articular surfaces, adequate fracture reduction, and anatomical restoration of the joint surface and aids in thorough joint lavage to remove the intraarticular debris.