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Outcomes of arthroscopic-assisted lateral tibial plateau fixation: a systematic review

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Abstract

Purpose

The purpose of this study is to evaluate and summarize the current literature on outcomes of arthroscopic-assisted tibial plateau fixation (AATPF) when applied for only lateral tibial plateau fractures.

Methods

A comprehensive search of nine databases was conducted: ClinicalTrials.gov, Cochrane Library via Wiley, Embase and MEDLINE via Ovid, Global Index Medicus, PubMed, Scopus, SPORTDiscus via EBSCO, and Web of Science Core Collection. The study was performed in concordance with PRISMA guidelines. Studies eligible for inclusions included Schatzker I–III lateral tibial plateau fractures with a minimum of 6-month follow-up. Data extraction was performed by two authors independently using a predesigned form.

Results

A total of 17 studies, 7 prospective and 10 retrospective, including 565 patients (age 15–82 years old) treated with AATPF were included in this review with follow-up ranging from 6 to 138 months. All 10 studies that used categorical functional outcomes demonstrated excellent/very good or good outcomes in > 90% of patients. When compared to patients managed with the traditional open reduction internal fixation (ORIF), patients treated with AATPF had statistically significantly better range of motion mean difference [5.21° (95% CI − 2.50 to 12.92, p < 0.0001)], lower blood loss [66.19 mL (95% confidence interval (CI) 32.54–99.84 mL, p < 0.0001)], shorter hospital stay [− 1.41 days (95% CI − 3.39 to 0.58 days, p < 0.0001)], better Hospital Special Surgery score [11.31 (95% CI 6.49–16.12, p < 0.0001)], and higher Rasmussen radiographic score [1.26 (95% CI − 0.72 to 3.23, p < 0.0001)].

Conclusion

AATPF is a promising treatment of lateral tibial plateau fractures with some advantages over the traditional ORIF.

Level of evidence

Therapeutic Level III.

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Funding

The authors declared that we did not receive any funding for the project and that there is no competing interest pertaining to this project.

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Authors and Affiliations

  1. Regions Hospital, 640 Jackson Street, Saint Paul, MN, 55101, USA

    Mai P. Nguyen & Thomas Z. Paull

  2. University of Minnesota, 2450 Riverside Ave, Suite R200, Minneapolis, MN, 55455, USA

    Mai P. Nguyen, Nicholas P. Gannon, Thomas Z. Paull, Caitlin Bakker & Marc F. Swiontkowski

  3. McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada

    Sofia Bzovsky & Sheila Sprague

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  1. Mai P. Nguyen
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Correspondence to Mai P. Nguyen.

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Nguyen, M.P., Gannon, N.P., Paull, T.Z. et al. Outcomes of arthroscopic-assisted lateral tibial plateau fixation: a systematic review. Eur J Orthop Surg Traumatol 33, 1473–1483 (2023). https://doi.org/10.1007/s00590-022-03339-3

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