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Balloon tibioplasty for reduction of depressed tibial plateau fractures: Preliminary radiographic and clinical results

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Abstract

Purpose

In vitro studies have shown promising results for balloon-guided inflation tibioplasty. It was our hypothesis that this technique may be safe and effective for use in depressed lateral tibial plateau fracture.

Methods

We performed a prospective study of all patients suffering from a depressed lateral tibial plateau fracture, managed in our institution with inflation tibioplasty and a resorbable calcium phosphate bone substitute injection, between January 2012 and December 2013. Twenty patients, mean age 54.3 ± 12. 8 years, suffering from a depressed lateral tibial plateau fracture (Schatzker type II and III) were included. We then aimed to evaluate at a minimum follow-up of one year: (1) the rate of complications, (2) the clinical outcome (Knee Injury and Osteoarthritis Outcome (KOO) and 12-Item Short Form Health Survey (SF-12) scores); and (3) the radiographic outcome (evaluated by CT-scan).

Results

No peri-operative complications occurred. In one patient, calcium phosphate substitute was found in the infrapatellar fat pad on post-operative radiography with no clinical or radiographic consequences at one year. At one year after surgery, the KOO subscores were: Pain 80 (range 64—93), other symptoms 81.3 (69–93), daily living activities 81.9 (46–99), sport 65.83 (20–100), and quality of life 67.04 (31–100). The SF-12 activity component was 40.4 (28.6—52.2) and SF-12 mental component 47.71 (28 – 67.1). The mean depressed step-off of the lateral joint decreased from 10.7 ± 4.8 mm pre-operatively to 2.7 ± 1.7 mm post-operatively (p < 0.0001).

Conclusion

Our observations suggest that the use of balloon-guided inflation tibioplasty with injection of a resorbable bone substitute is safe, and results in a high rate of anatomic reduction and good clinical outcomes in patients with depressed tibial plateau fractures.

Level of Evidence: Therapeutic Level IV.

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References

  1. Petersen W, Zantop T, Raschke M (2006) Fracture of the tibial head. Unfallchirurg 109(3):219–232

    Article  CAS  PubMed  Google Scholar 

  2. Manidakis N, Dosani A, Dimitriou R, Stengel D, Matthews S, Giannoudis P (2010) Tibial plateau fractures: functional outcome and incidence of osteoarthritis in 125 cases. Int Orthop 34(4):565–570

    Article  PubMed  Google Scholar 

  3. Dang A, Kim H (2009) Chondrocyte apoptosis after simulated intraarticular fracture: a comparison of histologic detection methods. Clin Orthop Relat Res 467(7):1877–1884

    Article  PubMed  PubMed Central  Google Scholar 

  4. Rademakers MV, Kerkhoffs GMMJ, Sierevelt IN, Raaymakers ELFB, Marti RK (2007) Operative treatment of 109 tibial plateau fractures: five- to 27-year follow-up results. J Orthop Trauma 21(1):5–10

    Article  CAS  PubMed  Google Scholar 

  5. Broome B, Mauffrey C, Statton J, Voor M, Seligson D (2012) Inflation osteoplasty: in vitro evaluation of a new technique for reducing depressed intra-articular fractures of the tibial plateau and distal radius. J Orthop Traumatol 13(2):89–95

    Article  PubMed  PubMed Central  Google Scholar 

  6. Pizanis A, Garcia P, Pohlemann T, Burkhardt M (2012) Balloon tibioplasty: a useful tool for reduction of tibial plateau depression fractures. J Orthop Trauma 26(7):e88–e93

    Article  PubMed  Google Scholar 

  7. Ahrens P, Sandmann G, Bauer J, König B, Martetschläger F, Müller D, Siebenlist S, Kirchhoff C, Neumaier M, Biberthaler P, Stöckle U, Freude T (2012) Balloon osteoplasty—a new technique for reduction and stabilisation of impression fractures in the tibial plateau: a cadaver study and first clinical application. Int Orthop 36(9):1937–1940

    Article  PubMed  PubMed Central  Google Scholar 

  8. Mauffrey C, Fader R, Hammerberg EM, Hak D, Stahel P (2013) Incidence and pattern of technical complications in balloon-guided osteoplasty for depressed tibial plateau fractures: a pilot study in 20 consecutive patients. Patient Saf Surg 7(1):8–8

    Article  PubMed  PubMed Central  Google Scholar 

  9. Jordan R, Hao J, Fader R, Gibula D, Mauffrey C (2013) Study protocol: trial of inflation osteoplasty in the management of tibial plateau fractures. Eur J Orthop Surg Traumatol 24:647

    Article  PubMed  Google Scholar 

  10. Ornetti P, Parratte S, Gossec L, Tavernier C, Argenson JN, Roos EM, Guillemin F, Maillefert JF (2008) Cross-cultural adaptation and validation of the French version of the Knee injury and Osteoarthritis Outcome Score (KOOS) in knee osteoarthritis patients. Osteoarthr Cartil 16(4):423–428

    Article  CAS  PubMed  Google Scholar 

  11. Ware J, Kosinski M, Keller SD (1996) A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care 34(3):220–233

    Article  PubMed  Google Scholar 

  12. Heiney J, Redfern R, Wanjiku S (2013) Subjective and novel objective radiographic evaluation of inflatable bone tamp treatment of articular calcaneus, tibial plateau, tibial pilon and distal radius fractures. Injury 44(8):1127–1134

    Article  PubMed  Google Scholar 

  13. Messina M, Herbert B, Mauffrey C (2013) The use of arthroscopy to assist reduction of depressed tibial plateau fractures. Curr Orthop Pract 24(2):160–164. doi:10.1097/BCO.0b013e318286d227

  14. Siegler J, Galissier B, Marcheix PS, Charissoux JL, Mabit C, Arnaud JP (2011) Percutaneous fixation of tibial plateau fractures under arthroscopy: a medium term perspective. Orthop Traumatol Surg Res 97(1):44–50

    Article  CAS  PubMed  Google Scholar 

  15. Biggi F, Di Fabio S, D’Antimo C, Trevisani S (2010) Tibial plateau fractures: internal fixation with locking plates and the MIPO technique. Injury 41(11):1178–1182

    Article  CAS  PubMed  Google Scholar 

  16. Young MJ, Barrack RL (1994) Complications of internal fixation of tibial plateau fractures. Orthop Rev 23(2):149–154

    CAS  PubMed  Google Scholar 

  17. Basques BA, Webb ML, Bohl DD, Golinvaux NS, Grauer JN (2015) Adverse events, length of stay, and readmission after surgery for tibial plateau fractures. J Orthop Trauma 29(3):e121–126

    Article  PubMed  Google Scholar 

  18. Chen X-Z, Liu C-G, Chen Y, Wang L-Q, Zhu Q-Z, Lin P (2014) Arthroscopy-assisted surgery for tibial plateau fractures. Arthroscopy 31(1):143–153

    Article  PubMed  Google Scholar 

  19. Belanger M, Fadale P (1997) Compartment syndrome of the leg after arthroscopic examination of a tibial plateau fracture. Case report and review of the literature. Arthroscopy 13(5):646–651

    Article  CAS  PubMed  Google Scholar 

  20. Dall’oca C, Maluta T, Lavini F, Bondi M, Micheloni GM, Bartolozzi P (2012) Tibial plateau fractures: compared outcomes between ARIF and ORIF. Strateg Trauma Limb Reconstr 7(3):163–175

    Article  Google Scholar 

  21. Simpson D, Keating JF (2004) Outcome of tibial plateau fractures managed with calcium phosphate cement. Injury 35(9):913–918

    Article  CAS  PubMed  Google Scholar 

  22. Weigel D, Marsh JL (2002) High-energy fractures of the tibial plateau. Knee function after longer follow-up. JBJS J Bone Jt Surg 84-A(9):1541–1551

    Google Scholar 

  23. Lachiewicz PF, Funcik T (1990) Factors influencing the results of open reduction and internal fixation of tibial plateau fractures. Clin Orthop Relat Res 259:210–215

    PubMed  Google Scholar 

  24. Lefkoe TP, Walsh WR, Anastasatos J, Ehrlich MG, Barrach HJ (1995) Remodeling of articular step-offs. Is osteoarthrosis dependent on defect size? Clin Orthop Relat Res 314:253–265

    PubMed  Google Scholar 

  25. Chang E-C, Lee J-S, Jung H-S (2014) Second-look arthroscopy after surgical treatment of Schatzker type II plateau fractures through the lateral submeniscal approach. Arch Orthop Trauma Surg 134(4):495–499

    Article  PubMed  Google Scholar 

  26. Hannouche D, Duparc F, Beaufils P (2006) The arterial vascularization of the lateral tibial condyle: anatomy and surgical applications. Surg Radiol Anat 28(1):38–45

    Article  PubMed  Google Scholar 

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The investigations were performed at St. Marguerite Hospital, Aix-Marseille University, Marseille, France.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, APHM, Institut du mouvement et de l’appareil locomoteur, Sainte-Marguerite Hospital, 13009, Marseille, France

    Matthieu Ollivier, Marco Turati, Maxime Munier, Alexandre Lunebourg, Jean-Noel Argenson & Sebastien Parratte

  2. CNRS, ISM UMR 7287, Aix-Marseille University, 13009, Marseille, France

    Matthieu Ollivier, Marco Turati, Maxime Munier, Alexandre Lunebourg, Jean-Noel Argenson & Sebastien Parratte

  3. Orthopedic Department, San Gerardo Hospital, Monza, Italy

    Marco Turati

Authors
  1. Matthieu Ollivier
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  2. Marco Turati
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  3. Maxime Munier
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  4. Alexandre Lunebourg
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  5. Jean-Noel Argenson
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  6. Sebastien Parratte
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Correspondence to Sebastien Parratte.

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Ollivier, M., Turati, M., Munier, M. et al. Balloon tibioplasty for reduction of depressed tibial plateau fractures: Preliminary radiographic and clinical results. International Orthopaedics (SICOT) 40, 1961–1966 (2016). https://doi.org/10.1007/s00264-015-3047-5

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  • DOI: https://doi.org/10.1007/s00264-015-3047-5

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