Background: Posterior tibial plateau fractures can lead to significant posttraumatic instability if not treated properly. It remains unclear which surgical approach achieves better patient outcomes. The objective of this systematic review and meta-analysis was to assess postoperative outcomes in patients undergoing anterior, posterior, or combined approach for posterior tibial plateau fractures.
Methods: The PubMed, Embase, Web of Science, The Cochrane Library, and Scopus were searched for studies published before October 26, 2022, comparing anterior, posterior, or combined approaches for posterior tibial plateau fractures. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Outcomes included complications, infections, range of motion (ROM), operation time, union rates, and functional scores. Significance was set at p < 0.05. Meta-analysis was conducted with STATA software.
Results: In total, 29 studies with a total of 747 patients were included for quantitative and qualitative analysis. Compared with other approaches, the posterior approach for posterior tibial plateau fractures was associated with a better ROM and shorter operative time. The complication rates, infection rates, union time, and hospital for special surgery (HSS) scores were not significantly different between surgical approaches.
Conclusions: The posterior approach for posterior tibial plateau fractures offers advantages such as improved ROM and shorter operative time. However, there are concerns regarding prone positioning in patients with medical or pulmonary comorbidities and indications in polytrauma cases. Further prospective studies are needed to determine the optimal approach for these fractures.
Level Of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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http://dx.doi.org/10.2106/JBJS.RVW.23.00030 | DOI Listing |
Background: The cementation technique is crucial for achieving adequate fixation and optimal survivorship in total knee arthroplasty (TKA). The thickness of the cement at the tibial bone-implant surface may be related to aseptic tibial loosening. However, to date, no studies have demonstrated a direct association between cement thickness and rates of aseptic tibial loosening.
View Article and Find Full Text PDFJ Plast Reconstr Aesthet Surg
November 2024
docPaulClinic, Private Plastic Surgery Unit, Bytom, Poland; Jan Dlugosz University, Czestochowa, Poland. Electronic address:
Lower limb injuries resulting from sports activities, industrial accidents, and traffic incidents represent a significant global healthcare challenge. These injuries often entail a high risk of complications, especially when fractures are associated with substantial soft tissue damage. Open fractures classified as Gustilo type II or III are particularly susceptible to complications such as fistula and osteomyelitis.
View Article and Find Full Text PDFArch Orthop Trauma Surg
December 2024
Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Purpose: The failure rate following posterolateral corner reconstruction (PLC) remains high. Previous research indicates that in posterior cruciate ligament (PCL) reconstruction the laxity is affected by the tibial slope (TS). However, there is currently no literature evaluating the impact of TS on surgical outcome in combined reconstruction of PLC/PCL.
View Article and Find Full Text PDFJ Exp Orthop
October 2024
Department of Orthopaedic Surgery, Faculty of Medicine The University of Tokyo Bunkyo-ku Tokyo Japan.
Purpose: The efficacy of medial pivot total knee arthroplasty (MP TKA) in treating valgus knees that may cause medial instability is unknown. The purpose of this study was to investigate the in vivo kinematics of MP TKA for the valgus knees and compare them to those for the varus knees.
Methods: The kinematics of 19 valgus knees and 19 varus knees operated in the MP TKA were investigated under fluoroscopy during squatting using a two- to three-dimensional registration technique.
J Exp Orthop
October 2024
Department of Orthopaedics and Traumatology, Aix Marseille Univ, APHM, CNRS, ISM, Sainte-Marguerite Hospital Institute for Locomotion Marseille France.
Purpose: This study assessed the measurements of the medial posterior tibial slope (MPTS) using long radiographs and three-dimensional (3D) computed tomography (CT) scans and compared them to measurements taken on short lateral knee radiographs. The study aimed to identify whether the at-risk slope measurements previously defined on the short radiographs would be similar to long radiographs and 3D CT scans.
Methods: A retrospective radiological review of 52 cases, who underwent planning for a slope-changing high tibial osteotomy and had short and long lateral radiographs and 3D CT scans of the tibia.
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