Comparison of Arthroscopic Assisted Reduction and Internal Fixation Versus Open Reduction and Internal Fixation in Tibia Plateau Fracture Treatment: A Prospective Cohort Study With Historical Controls

Abstract

Background: Orthopedic surgery of tibial plateau fractures has been a challenging procedure for a long duration. However, less-invasive surgical techniques have recently been developed for this condition.
Objectives: In an interventional study with a historical control, we evaluated the medium-term functional and radiological outcomes of treatments for tibial plateau fractures using the arthroscopically assisted reduction and internal fixation (ARIF) and open reduction and internal fixation (ORIF) techniques.
Patients and Methods: Eleven patients with tibial plateau fractures of Schatzker types I-VI were treated with ARIF, whereas 11 patients were matched historically as the ORIF group. There were no significant differences in gender, age, and fracture types between the groups (P > 0.05). At the last follow-up, range of motion, visual analogue score for pain, Rasmussen functional and radiographic scores, international knee society scoring system (IKSS) score, and the Ahlback radiologic scale score for osteoarthritis were evaluated.
Results: All patients achieved union. The ARIF group had a shorter rehabilitation period, as well as a lower rate of midterm osteoarthritis and complications (P < 0.05). There were no significant differences between both groups according to other functional and radiologic assessments.
Conclusions: We recommend that the ARIF technique is an acceptable alternative treatment for tibial plateau fractures, with good functional and radiological midterm results and without serious complications.