Arthroscopic management of tibial plateau fractures--comparison with open reduction method.

BACKGROUND: Arthroscopic treatment of tibial plateau fractures were compared with open traditional methods retrospectively. METHODS: Twenty-eight patients were included in this comparative study based on fracture patterns and divided into two groups. Using Schatzker's classification system, patients with type II (split depression), type III (isolated depression) fractures, or other fracture types were included. Nineteen of these patients were treated by arthroscopically assisted management (group S), and the remaining 9 underwent the conventional open method (group O). RESULTS: There was no significant difference between both groups in terms of duration of operation, postoperative flexion, and clinical results. In group S, however, the postoperative rehabilitation was easier and faster (the time to obtain 120 degrees of flexion was 4.6+/-3.9 weeks in group S, 9.1+/-8.6 weeks in group O). Furthermore, 16 of 19 patients (84%) in group S obtained an anatomical reduction (defined as <2 mm of residual displacement after surgery), whereas in group O, only 5 of 9 patients (55%) had an anatomical reduction. Also, accurate diagnosis and treatment of any associated joint pathology was possible with arthroscopic management. CONCLUSION: The arthroscopic procedure is recommended in selected tibial plateau fractures.

Unicompartmental knee arthroplasty for lateral gonarthrosis: midterm results.

Thirty-eight lateral compartment arthroplasties were performed in 22 years. Eighteen joints in 17 patients with an average age of 64.5 years were evaluated with minimum 5-year follow-up. Using the Hospital for Special Surgery knee score, 16 of 18 joints had satisfactory results in terms of function and pain relief. The average preoperative alignment on standing was 14.9 degrees of valgus angulation, which was corrected to 6.9 degrees of valgus. On radiographic analysis, no radiolucent lines were seen under the tibial component, but the femoral component was loose in 1 joint. Although 5 joints showed slight deterioration of osteoarthritic change in the medial compartment, lateral compartment arthroplasty is a reliable and successful option in the treatment of patients with a low level of physical activity.