RESUMO
OBJECTIVE: Functional outcome of Intraarticular Tibial Plateau Fractures fixed with precontoured anatomical plates using Knee Society Score. METHODS: Observational study with retrospective review of collected data. Patient's demography, mechanism of injury, schatzker's classification includingtype IV, V and VI. All patients underwent screw and plate fixation using two incision technique with pre-contoured anatomical plates and intercondylar lag screws where indicated. Passive range of motion exercises started at 2 weeks. Postoperative knee pain, range of motion and stiffness were recorded at followup 3 and 4 months. Mean±SD were calculated for quantitative variables and qualitative variables were presented with frequency and percentages. The association of outcome (Knee Society Score) with gender, age and Schatzker's type was evaluated by applying Fisher's Exact test considering p-value <0.05 as significant. RESULTS: Twenty-five patients were included in study. 20 patients were available and 05 lost to follow up. 16 were males and 4 females out of 20 patients. Average age is 36.2±12.89 years. All patients sustained injuries after RTA. 5 patients had postoperative knee pain while remaining were pain free. Average flexion was 123.8 with (SD 8.88)range of 105 to 135 degree. Average extension was 3.15 with (SD 2.41) range of 0 to 8 degress. 4 patients developed stiffness of knee. 2 patients symptomatic implant. All fractures healed at follow up at 4 months. According to Knee Society score (SD 7.65) 14 cases scored as good, 4 cases scored fair and 2 cases scored poor. There was no association of knee score was found with gender (p=0.493) but significant association of knee score was found with age (p=0.007) and Schatzker's type (p=0.028). CONCLUSIONS: Tibial plateau fractures can be effectively treated by anatomical reduction and absolute fixation using pre-contoured anatomical plates. Functional outcome calculated by Knee Society score is better in young patients. With appropriate surgical techniques and early post-operative rehabilitation, good functional results can be achieved.
RESUMO
PURPOSE: To evaluate the mid-term functional outcome using Lysholm score of anterior cruciate ligamentreconstruction using bone patella-tendon bone graft. METHODS: The retrospective study of prospectively collected data was conducted at Liaquat National Hospital, Karachi, from June 2010to June 2013, and comprised patients with complete anterior cruciate ligamenttear who were treated with diagnostic arthroscopy and open reconstruction using bone patella-tendon bone graft. All patients were operated under tourniquet control and knee immobiliser was applied. Straight leg raise procedure was started on 2nd postoperative day. One year after surgery, functional outcome was assessed using Lysholm score. RESULTS: All the 36(100%) patients in the study were males. Four (11%) patients were lost to follow-up and were excluded, while 32(89%) completed the study. Right knee was involved in 16(50%) patients while left knee was involved in 16(50%) patients. Overall, 31(97%) patients had history of contact sports injury. The average age of patients was 28.25±8.32 years. All patients were operated at an average of 17.5±10.3 weeks. The ligament tear was associated with medial meniscal tear in 16(50%) patients, while lateral meniscal tear was noted in 10(31.25%). The mean Lysholm score was 83.06±4.17at 1 year (fair to good outcome). The average range of motion 1 year after surgery was 127.5±11.25. Loss of extension <3o was noted in 20(62.5%) patients, while >3o was noted in 12(37.5%). The average loss of extension was 3.5±2.3 degrees. Two (6.25%) patients developed superficial infection which subsided with oral antibiotics. Anterior knee pain was reported by 8(25%) patients. CONCLUSIONS: Patellar bone tendon bone graft was a reliable method for reconstruction of anterior cruciate ligament.
