Arthroscopically assisted reduction and internal fixation (ARIF) versus open reduction and internal fixation (ORIF) for lateral tibial plateau fractures: a comparative retrospective study

• Main Authors: Marco Verona, Giuseppe Marongiu, Gaia Cardoni, Nicola Piras, Luca Frigau, Antonio Capone
• Format: Article
• Language: English
• Published: BMC 2019-05-01
• Series: Journal of Orthopaedic Surgery and Research
• Subjects: Tibial plateau fractures; Arthroscopic reduction and internal fixation (ARIF); Open reduction and internal fixation (ORIF); Arthroscopically assisted; Schatzker classification; Post-traumatic knee osteoarthritis
• Online Access: http://link.springer.com/article/10.1186/s13018-019-1186-x

Abstract Background This study aims to explore if the arthroscopically assisted reduction and internal fixation (ARIF) technique is superior to the traditional open reduction and internal fixation (ORIF) technique in the treatment of tibial lateral plateau fractures. Methods Forty patients with tibial plateau fractures (Schatzker type I–III) treated with ARIF or ORIF from 2012 to 2017 were included in this retrospective study. All patients received pre-operative radiographs and CT scans. The patients were divided into two groups (ARIF or ORIF). All patients had a minimum follow-up of 12 months and an average follow-up of 44.4 months. The clinical and radiographic outcomes were evaluated according to the Knee Society Score (KSS) and the modified Rasmussen radiological score. Results Satisfactory clinical and radiological results were found in 39 out of 40 (97.5%) patients. KSS and modified Rasmussen radiological score were significantly better in ARIF group. The mean KSS was 92.37 (± 6.3) for the ARIF group and 86.29 (± 11.54) for the ORIF group (p < 0.05). The mean modified Rasmussen radiographic score was 8.42 (± 2.24) for the ARIF group and 7.33 (± 1.83) for the ORIF group (p = 0.104). Worst clinical and radiological results were related to concomitant intra-articular lesions (p < 0.05). Meniscal tears were found and treated in 17 out of 40 (42.5%) patients. The overall complication rate was 10%. Conclusions Both ARIF and ORIF provided a satisfactory outcome for the treatment of Schatzker I–III tibial plateau fractures. However, ARIF led to better clinical results than ORIF. No statistically significant differences were found in perioperative complications, radiological results, and post-traumatic knee osteoarthritis. Level of evidence Level III