Prevalence of knee stiffness after arthroscopic bone suture fixation of tibial spine avulsion fractures in adults - 16/08/16
, N.C. Barbosa, R. Gardon, S. Tuteja, R. Chatellard, J.-M. Fayard, B. Sonnery-Cottet
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Abstract |
Background |
Tibial spine avulsion fractures (TSAFs) occur chiefly in adolescents. Few published data are available on outcomes after arthroscopic surgical treatment of TSAFs in adults.
Objectives |
To evaluate outcomes of consecutive patients with TSAFs managed by arthroscopic bone suture followed by a standardised non-aggressive rehabilitation programme.
Hypothesis |
Arthroscopic bone suture followed by non-aggressive rehabilitation therapy reliably produces satisfactory outcomes in adults with TSAF.
Methods |
Thirteen adults were included. Outcomes were evaluated based on the Tegner score, International Knee Documentation Committee (IKDC) score, anterior-posterior knee laxity, passive and active motion ranges, and radiological appearance.
Results |
After a mean follow-up of 41±27months (12–94months), all 13 patients had healed fractures without secondary displacement. No patient had knee instability. Post-operative stiffness was noted in 5 patients (2 with complex regional pain syndrome and 3 with extension lag), 1 of whom required surgical release. The mean IKDC score was 91.3±11.7. The mean Tegner score was 5.46±1.37 compared to 6.38±0.70 before surgery. Mean tibial translation (measured using the Rolimeter) was 1.09±1.22mm, compared to 5.9±1.85mm before surgery.
Conclusion |
The outcomes reported here support the reliability of arthroscopic bone suture for TSAF fixation. Nevertheless, a substantial proportion of patients experienced post-operative stiffness, whose contributory factors may include stunning of the quadriceps due to the short time from injury to surgery and the use of a gentle rehabilitation programme.
Level of evidence |
IV, retrospective study of treatment outcomes.
El texto completo de este artículo está disponible en PDF.Keywords : Knee, Tibial spine avulsion fractures, Arthroscopic bone suture, Complications, Extension lag, Stiffness
Esquema
Vol 102 - N° 5
P. 625-629 - septembre 2016 Regresar al número
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Bienvenido a EM-consulte, la referencia de los profesionales de la salud.