Clinical results after surgical treatment of posterolateral tibial plateau fractures ("apple bite fracture") in combination with ACL injuries.
Anterior Cruciate Ligament Injuries
/ diagnostic imaging
Arthroscopy
Bone Screws
Bone Transplantation
Female
Fracture Fixation, Internal
/ methods
Humans
Joint Instability
/ prevention & control
Knee Joint
/ diagnostic imaging
Male
Middle Aged
Recovery of Function
Retrospective Studies
Tibial Fractures
/ diagnostic imaging
Journal
European journal of trauma and emergency surgery : official publication of the European Trauma Society
ISSN: 1863-9941
Titre abrégé: Eur J Trauma Emerg Surg
Pays: Germany
ID NLM: 101313350
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
received:
13
06
2020
accepted:
19
09
2020
pubmed:
28
9
2020
medline:
23
6
2021
entrez:
27
9
2020
Statut:
ppublish
Résumé
The anterior cruciate ligament (ACL)-tear is a common injury in orthopaedic trauma. Depending on the energy of impact fractures of the posterolateral tibial plateau are often associated. Different morphologic variants of posterolateral tibial plateau impaction fractures have been described in the setting of an ACL-tear. Up to now an algorithm of treatment for a combined injury of a posterolateral tibial head fracture and an injury to the anterior cruciate ligament is missing. We present a retrospective study with clinical and radiological analysis of posterolateral fractures in combination with ACL-tear. Impressions with a depth of more than 2 mm and/or a width that outreaches more than half of the posterior horn of the lateral meniscus with additional 3. degree positive pivot-shift-test indicated surgical treatment of the fracture with additional ACL repair or reconstruction. Clinical evaluation included follow-up examination, Visual Analog Scale (VAS), International Knee Documentation Committee Score (IKDC), functional and radiological Rasmussen score. 20 patients were included with a mean age of 43.6 ± 12.4 years. Mean follow-up was 18,2 ± 13,5 months. The fracture was arthroscopically reduced and percutaneously fixed with a screw osteosynthesis (Group 1), reduced via a dorsal approach without (Group 2) or with an autologous bone graft (Group 3). Subjective IKDC score was 79,15 ± 6,07. Functional Rasmussen scores ranged from 27 to 30 (mean 28 ± 2.71). Radiological Rasmussen scores ranged from 16 to 18 points (mean 16.75 ± 1.33). According to IKDC score (p = 0.60), functional Rasmussen score (p = 0.829) and radiological Rasmussen score (p = 0.679) no significant discrepancy between the groups were seen. There was no failure of the ACL graft recorded. Posterolateral tibial plateau fractures in combination with an ACL-tear, can cause persistent instability and increase rotational instability. Indication for treatment of these fractures is still under debate. From the biomechanical aspect the lack of more than 50% of the posterior horn of the lateral meniscus and dislocation/depression of more than 2 mm results in an increased rotational instability of the ACL deficient knee. Combined surgical treatment with ACL repair or reconstruction is a safe procedure that results in good, short-term clinical outcome, if our algorithm is followed. In addition this study shows, that majority of posterolateral tibial plateau fractures can be treated arthroscopically.
Identifiants
pubmed: 32980883
doi: 10.1007/s00068-020-01509-8
pii: 10.1007/s00068-020-01509-8
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1239-1248Références
Sanders TL, Maradit Kremers H, Bryan AJ, Larson DR, Dahm DL, Levy BA, et al. Incidence of Anterior cruciate ligament tears and reconstruction: A 21-year population-based study. Am J Sports Med. 2016;44:1502–7.
doi: 10.1177/0363546516629944
Choi WR, Yang J-H, Jeong S-Y, Lee JK, Woloschak GE. MRI comparison of injury mechanism and anatomical factors between sexes in non-contact anterior cruciate ligament injuries. PLoS ONE. 2019;14:e0219586.
doi: 10.1371/journal.pone.0219586
Kim SY, Spritzer CE, Utturkar GM, Toth AP, Garrett WE, DeFrate LE. Knee kinematics during noncontact anterior cruciate ligament injury as determined from bone bruise location. Am J Sports Med. 2015;43:2515–21.
doi: 10.1177/0363546515594446
Na L, Wang W, Ye B, Wu S. Anisometry anterior cruciate ligament sport injury mechanism study: a finite element model with optimization method. Mol Cell Biomech. 2014;11:87–100.
pubmed: 25831856
Evans KN, Kilcoyne KG, Dickens JF, Rue J-P, Giuliani J, Gwinn D, et al. Predisposing risk factors for non-contact ACL injuries in military subjects. Knee Surg Sports Traumatol Arthrosc. 2012;20:1554–9.
doi: 10.1007/s00167-011-1755-y
Renstrom P, Ljungqvist A, Arendt E, Beynnon B, Fukubayashi T, Garrett W, et al. Non-contact ACL injuries in female athletes: an International Olympic Committee current concepts statement. Br J Sports Med. 2008;42:394–412.
doi: 10.1136/bjsm.2008.048934
Patel SA, Hageman J, Quatman CE, Wordeman SC, Hewett TE. Prevalence and location of bone bruises associated with anterior cruciate ligament injury and implications for mechanism of injury: A Systematic Review. Sports Med. 2014;44:281–93.
doi: 10.1007/s40279-013-0116-z
Cobby MJ, Schweitzer ME, Resnick D. The deep lateral femoral notch: an indirect sign of a torn anterior cruciate ligament. Radiology. 1992;184:855–8.
doi: 10.1148/radiology.184.3.1509079
Jiang L, Wu H, Yan S. Two cases of contact anterior cruciate ligament rupture combined with a posterolateral tibial plateau fracture. Case Reports in Orthopedics. 2015;2015:1–5.
doi: 10.1155/2015/250487
Krause M, Menzdorf L, Preiss A, Frosch K-H. Are there four tibial plateau columns? Yes there are, as illustrated by a postero-lateral apple-bite fracture. Response to a letter-to-the-editor. International Orthopaedics (SICOT). 2018;42:443–6.
doi: 10.1007/s00264-017-3686-9
Krause M, Preiss A, Müller G, Madert J, Fehske K, Neumann MV, et al. Intra-articular tibial plateau fracture characteristics according to the “Ten segment classification”. Injury. 2016;47:2551–7.
doi: 10.1016/j.injury.2016.09.014
Bernholt DL, DePhillipo NN, Grantham WJ, Crawford MD, Aman ZS, Kennedy MI, et al. Morphologic variants of posterolateral tibial plateau impaction fractures in the setting of primary anterior cruciate ligament tear. Am J Sports Med. 2020;48:318–25.
doi: 10.1177/0363546519893709
Herbort M. The "Bankart Knee“: Biomechanical consequences of a posterolateral tibia plateau impression fracture as concomitant injury of ACL rupture. Kitzbuehel; 2020.
Marouane H, Shirazi-Adl A, Hashemi J. Quantification of the role of tibial posterior slope in knee joint mechanics and ACL force in simulated gait. J Biomech. 2015;48:1899–905.
doi: 10.1016/j.jbiomech.2015.04.017
Ackermann C, Frings J, Alm L, Frosch K-H. Arthroscopic controlled closed reduction and percutaneous fixation of posterolateral tibia plateau impression fractures. Arthroscopy Techniques. 2019;8:e867–e874874.
doi: 10.1016/j.eats.2019.04.001
Weimann A, Heinkele T, Herbort M, Schliemann B, Petersen W, Raschke MJ. Minimally invasive reconstruction of lateral tibial plateau fractures using the jail technique: a biomechanical study. BMC Musculoskelet Disord. 2013;14:120.
doi: 10.1186/1471-2474-14-120
Frosch KH, Balcarek P, Walde T, Stürmer KM. A New Posterolateral approach without fibula osteotomy for the treatment of tibial plateau fractures. J Orthop Trauma. 2010;24(8):515–20.
doi: 10.1097/BOT.0b013e3181e5e17d
Rasmussen PS. Tibial condylar fractures. Impairment of knee joint stability as an indication for surgical treatment. J Bone Joint Surg Am. 1973;55:1331–500.
doi: 10.2106/00004623-197355070-00001
Irrgang JJ, Ho H, Harner CD, Fu FH. Use of the international knee documentation committee guidelines to assess outcome following anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 1998;6:107–14.
doi: 10.1007/s001670050082
Le Baron M, Cermolacce M, Flecher X, Guillotin C, Bauer T, Ehlinger M. Tibial plateau fracture management: ARIF versus ORIF - clinical and radiological comparison. Orthop Traumatol Surg Res. 2019;105(1):101–6.
doi: 10.1016/j.otsr.2018.10.015
Solomon LB, Stevenson AW, Lee YC, Braid RB. Posterolateral ans anterolateral approaches to unicondylar posterolateral tibial plateau fractures: a comparative study. J Injury. 2013;44(11):1561–8.
doi: 10.1016/j.injury.2013.04.024
Singleton N, Sahakian V, Dawson M. Outcome after tibial plateau fracture: How important is restoration of articular congruity? J Orthop Trauma. 2017;31(3):158–63.
doi: 10.1097/BOT.0000000000000762
Parkkinen M, Madanat R, Mustonen A, Koskinen SK, Paavola M, et al. Factors predicting the development of early osteoarthritis following lateral tibial plateau fractures mid-term clinical and radiographic outcomes of operatively treated patients. Scand J Surg. 2014;103(4):256–62.
doi: 10.1177/1457496914520854
Zhang W, Luo CF, Putnis S, Sun H, Zeng ZM, Zeng BF. Biomechanical analysis of four different fixations for the posterolateralshearing tibial plateau fracture. Knee. 2012;19(2):94–8.
doi: 10.1016/j.knee.2011.02.004