Arthroscopic assessment of cartilage healing status after treatment of tibial plateau fracture

Abstract

Background: There are a few reports on the healing status of the cartilage after the treatment of tibial plateau fracture. In this study, we analyzed the healing status of articular cartilage using second-look arthroscopy with clinical and radiological results from patient's in schatzker Type I, II, and III tibial plateau fracture. Materials and Methods: 43 patients operated between January 2011 and December 2013 were included in this retrospective study. Radiological evaluation was performed by comparing simple radiographs from the preoperative, postoperative, and final followup period. Clinical evaluations were performed using the Knee Society Knee Score (KSKS) and the Knee Society Functional Score (KSFS). Moreover, second-look arthroscopic evaluation was performed during implant removal, and cartilage healing status was classified according to the International Cartilage Repair Society grading system (ICRS). Results: In all 43 patients, bony union was achieved with a mean duration of 13.7 weeks. The degree of cartilage healing was poor when the step-off was high (P = 0.016). Furthermore, even in cases with satisfactory step-off <2 mm, there was no case with complete cartilage healing. Between ICRS grade and clinical results, the respective Pearson coefficient for KSKS and KSFS were r =-0.62 and r =-0.59 indicating mean statistically significant negative correlations (P = 0.001). Conclusion: Even though step off was reduced anatomically and clinical outcome was excellent or good, there was not always complete cartilage healing in a followup on second-look arthroscopy. Therefore, we focused on not only radiologic and clinical outcome but also the actual status of cartilage with second-look arthroscopy.