Role of arthroscopy in tibial plateau fractures

Bibliographic review

Abstract

Objective: The objective of this study is to explore the experience
and the results of the treatment of Schatzker(1) I-IV tibial plateau
fractures with the internal fixation technique (ARIF) with arthroscopic
assistance
Methodology: A systematic search was carried out in different
search engines, such as Pubmed and Lilacs. The same methodology
was applied by two independent reviewers using MESH terms “Tibial
Fracture”, “Arthroscopic”. Articles published in the last 5 years (2014
to September 2020) were included, showing clinical results of the
procedures, in English or Spanish, in humans and individuals 18 years
of age and older.
Results: Following the inclusion criteria, 114 titles were identified and finally 9 articles were included in our systematic review. Of
the 9 articles reviewed, 5 were case series (level of evidence IV), 3
retrospective comparative studies between open reduction and
internal fixation techniques (ORIF) and ARIF with level of evidence
III and one study was level of evidence I. A total of 217 patients
underwent ARIF surgery in our review, the average follow-up time
was 24.9 months (12-90 m), in terms of the type of fracture, the most
frequent were Schatzker II tibial plateau fractures and III, the most
frequent associated injury was meniscal injury followed by anterior
cruciate ligament tear. Regarding the total percentage of results
obtained independently of each score used, approximately 98%
obtained good or excellent results. The percentage of complications
with arthroscopic assistance turned out to be approximately 6.5%,
the most frequent complication being deep vein thrombosis with 6
cases.
Conclusions: From our review we can conclude that arthroscopic
assistance is useful in the treatment of Schatzker I-IV tibial plateau
fractures, since it provides satisfactory functional results, without
increasing the number of complications and allows treating
associated injuries simultaneously