Purpose: To compare outcomes of patients with posterior tibial plateau fractures who underwent repair indirectly with an anterior approach to those who underwent direct repair with a prone "Lobenhoffer" operative approach.
Methods: A total of 44 patients with a posterior column tibial plateau fracture that underwent repair were identified. Twenty-two patients with 22 tibial plateau fractures were fixed using a prone Lobenhoffer approach. They were compared to 22 patients treated with an indirect reduction using a supine approach for similar fracture patterns. Data collection at minimum 1 year included: patient-reported outcome scores (SMFA), patient-reported pain, knee range of motion, complications and need for reoperation. Radiographs were reviewed for knee alignment, residual depression and fracture healing.
Results: All demographics were similar between the groups except BMI, which was lower in the prone group (P < 0.05). Fracture type according to age, Schatzker and three-column classification was matched between cohorts. There was no difference in outcomes including: pain, radiographic knee alignment, residual articular depression, functional outcome (SMFA), complications and need for reoperations. Knee flexion at 1 year was greater in the prone group (127.8 vs. 115.8; P = 0.018). In addition, surgical time was less in the prone group (mean 73.7 min vs. 82.3 min; P = 0.015).
Conclusion: The Lobenhoffer approach with direct reduction of posterior fracture fragments for complex tibial plateau fractures is an excellent option for these injuries. It allowed for faster surgery with improved ultimate knee range of motion in posterior column tibial plateau fractures.
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http://dx.doi.org/10.1007/s00590-023-03755-z | DOI Listing |
Am J Sports Med
January 2025
Twin Cities Orthopedics, Edina, Minnesota, USA.
Background: Anterior cruciate ligament (ACL) stress techniques-including single-leg stress radiographs, Telos, and KT-1000 arthrometer-are highly accessible and can provide additional diagnostic information to assess ACL and ACL graft integrity. The degree of anterior tibial translation (ATT) may be useful in guiding treatment when a diagnosis on magnetic resonance imaging is not conclusive or for judging if additional treatments, such as anterolateral complex augmentation, may be necessary.
Purpose/hypothesis: The purpose of this study was to evaluate the effect of increasing posterior tibial slope (PTS) on baseline tibial position (BTP) and side-to-side differences (SSD) in ATT.
J Vet Sci
October 2024
Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea.
Importance: Patients with arthritis and ruptured cruciate ligaments typically require surgery. Following surgery, it is necessary to improve joint function in early stage.
Objective: This study aimed to investigate the impact of intraoperative intra-articular injection of the ELHLD peptide (L-glutamyl-L-leucyl-L-histidyl-L-leucyl-L-aspartic acid) on postoperative stifle function in patients with medial patella luxation grade 3 and osteoarthritis grade 2 undergoing tibial plateau leveling osteotomy due to anterior cruciate ligament (ACL) rupture.
J ISAKOS
December 2024
Twin Cities Orthopedics, Edina, Minnesota, USA. Electronic address:
Medial meniscus ramp tears are tears of the posteromedial capsule or peripheral rim of the posteromedial meniscus that frequently occur with anterior cruciate ligament (ACL) tears. The incidence and prevalence of medial meniscus ramp tears has been increasing in the recent literature due to the increased understanding of the anatomy and diagnosis of these tears. When a patient presents with an ACL tear, a medial meniscus ramp tear should be suspected if the patient has a grade 3+ Lachman or pivot shift exam, a vertical line of increased signal intensity in the posterior capsule or peripheral meniscus on magnetic resonance imagining (MRI), or posteromedial tibial plateau bone bruising on MRI.
View Article and Find Full Text PDFAm J Vet Res
January 2025
Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, Pretoria, South Africa.
Objective: The aim was to investigate the patellar ligament strain with varying degrees of tibial plateau angles (TPAs) after tibial plateau leveling osteotomy (TPLO) in a cranial cruciate ligament (CrCL)-deficient stifle during the stance phase.
Methods: 12 pelvic cadaver limbs were secured to a custom-built jig to mimic a loadbearing stance after which an axial load of 120 N was applied. Patellar ligament strain, change in strain, and percent change in strain were calculated on pre-TPLO (intact and transected CrCL) and post-TPLO tibial TPAs of -5°, 0°, 5°, 10°, and 15°.
Cureus
December 2024
Orthopedics and Traumatology, Unidade Local de Saúde da Cova da Beira, Covilhã, PRT.
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