Arthroscopy-assisted surgery for tibial plateau fractures: 2-to 10-year follow-up results

Purpose: This study evaluated the outcome of arthroscopy-assisted reduction with internal fixation for treating tibial plateau fractures at 2- to 10-year follow-up. Methods: Fifty-four patients with tibial plateau fractures treated by arthroscopy-assisted reduction with internal fixation were enrolled in this prospective study. According to the Schatzker classification, the fractures types were as follows: type I, 1 (2%); type II, 21 (39%); type III, 4 (7%); type IV, 10 (19%); type V, 8 (15%); and type VI, 10 (19%). The mean age at operation was 48 years (range, 22 to 68 years). The mean follow-up period was 87 months (range, 28 to 128 months). Clinical and radiologic outcomes were scored by the Rasmussen system. Results: The mean postoperative Rasmussen clinical score was 28.4 (range, 19 to 30), and the mean radiologic score was 16.1 (range, 12 to 18). Good or excellent clinical and radiologic results were achieved in 96% of patients. The 6 fracture types did not significantly differ with regard to Rasmussen score or rate of satisfactory results (P > .05). Secondary osteoarthritis was noted in 10 injured knees (19%). All 54 fractures were successfully united. The mean preoperative fracture depression was 13.7 mm (range, 6 to 25 mm). Fracture depression at the final follow-up averaged 0.3 mm (range, 0 to 4 mm). No complications directly associated with arthroscopy were noted in any of the 54 patients. Conclusions: Arthroscopic surgery for tibial plateau fractures with associated soft-tissue injuries is a safe, reproducible, and effective procedure that provides precise diagnosis and effective treatment in a 1-stage procedure. Level of Evidence: Level IV, therapeutic case series.