Abstract
The goal of this study was to evaluate the results of a novel method, arthroscopic
fixation of isolated Hoffa fractures.This is a prospective, case series and set at
Level 1 trauma center. A total of eight patients with isolated Hoffa fractures who
were operated by arthroscopic screw fixation method in the anterior posterior direction
with 6.5 mm cannulated screws were followed up prospectively. Same surgical method
used for all patients. All patients underwent the same rehabilitation program and
active range of motion (ROM) exercises were started immediately. The International
Knee Society (IKS) knee and functional scores, postoperative knee ROMs, and time of
bone union were used as outcome measurements. Postoperative knee ROMs was compared
with the contralateral healthy knee. The mean follow-up time was 29 months (26 − 41
months). At the final review, no significant difference (p = 0.159) was found between the ROM of healthy side and operated side of patients
(153.1 ± 4.6 and 150 ± 3.8). The mean IKS knee and functional scores at 12 months
were 87.2 ± 5.8 and 96.8 ± 3.7, respectively. Union was achieved in all patients at
a mean duration of 3.8 months. Fracture side had no influence on the IKS knee scores,
functional scores, and ROM (p = 0.846, p = 0.913, and p = 0.374, respectively). Concomitant intra-articular lesions identified in two patients
(%25) during arthroscopy were one anterior cruciate ligament rupture and one medial
meniscus tear. Patients undergoing arthroscopic Hoffa fracture fixation have excellent
outcomes at average 29 months postoperatively with no apparent complications and no
significant loss of ROM. Also 25% of patients had intra-articular injuries that were
identified with arthroscopic technique that may have been missed with the open technique.
The level of evidence was Level 4 (case series).
Keywords
Hoffa fracture - distal femur - arthroscopic fixation - intra-articular fracture
