J Knee Surg 2023; 36(07): 695-701
DOI: 10.1055/s-0041-1741392
Original Article

A Comparative Study of Clinical Outcomes and Functional Status after Knee Fracture and Knee Fracture Dislocation

Mackenzie L. Bird
1   NYU Langone Orthopedic Hospital, NYU Langone Health, New York, New York
,
Kristofer E. Chenard
1   NYU Langone Orthopedic Hospital, NYU Langone Health, New York, New York
,
Leah J. Gonzalez
1   NYU Langone Orthopedic Hospital, NYU Langone Health, New York, New York
,
Sanjit R. Konda
1   NYU Langone Orthopedic Hospital, NYU Langone Health, New York, New York
2   Department of Orthopedic Surgery, Jamaica Hospital Medical Center, New York, New York
,
Philipp Leucht
1   NYU Langone Orthopedic Hospital, NYU Langone Health, New York, New York
,
Kenneth A. Egol
1   NYU Langone Orthopedic Hospital, NYU Langone Health, New York, New York
› Author Affiliations
Funding None.

Abstract

The aim of this study was to compare outcomes of tibial plateau fracture dislocations (FD) with tibial plateau fractures alone. This study was an analysis of a series of tibial plateau fractures, in which FD was defined as a fracture of the tibial plateau with an associated loss of congruent joint reduction and stability of the knee, and classified by the Moore system. Patient data collected included demographics, injury information, and functional outcomes (short musculoskeletal function assessment [SMFA] score and Pain by the visual analog scale). Clinical outcomes at follow-up were recorded including knee range of motion, knee stability and development of complications. There were a total of 325 tibial plateau fracture patients treated operatively, of which 22.2% were identified as FD (n = 72). At injury presentation there was no difference with regard to nerve injury or compartment syndrome (both p > 0.05). FD patients had a higher incidence of arterial injury and acute ligament repair (both p < 0.005). At a mean follow-up of 17.5 months, FD patients were similar with regard to pain, total SMFA scores, and return to sports than their non-FD counterparts (p = 0.884, p = 0.531, p = 0.802). FD patients were found to have decreased knee flexion compared with non-FD patients by 5 degrees (mean: 120 and 125 degrees) (p < 0.05). FD patients also had a higher incidence of late knee instability and subsequent surgery for ligament reconstruction (p < 0.005 & p < 0.05). However, there was no difference in neurological function between groups at follow-up (p = 0.102). Despite the higher incidence of ligamentous instability and decreased range of motion, FD patients appear to have similar long-term functional outcomes compared with non-FD of the tibial plateau. While FD patients initially presented with a higher incidence of arterial injury, neurovascular outcomes at final follow-up were similar to those without a dislocation.

Note

Investigation was performed at the NYU Langone Orthopedic Hospital, New York NY and Jamaica Hospital Medical Center, Jamaica NY.


Ethical Approval

This study was approved by an institutional review board and subjects gave informed consent to participate. This study was performed in accordance with the World Medical Association Declaration of Helsinki.




Publication History

Received: 19 April 2021

Accepted: 16 November 2021

Article published online:
24 December 2021

© 2021. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
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