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Gait recovery is not associated with meniscus and/or knee ligament injuries following lateral tibial plateau fractures. A prospective 3-year cohort study of 56 patients - 19/08/23

Doi : 10.1016/j.otsr.2023.103569 
Peter Larsen a, b, Rasmus Elsoe b,
a Department of Occupational Therapy and Physiotherapy, Aalborg University Hospital, Aalborg, Denmark 
b Department of Orthopaedic Surgery, Aalborg University Hospital, Aalborg, Denmark 

Corresponding author. Aalborg University Hospital, Aalborg University, 18-22 Hobrovej, DK-9000 Aalborg, Denmark.Aalborg University Hospital, Aalborg University18-22 HobrovejAalborgDK-9000Denmark

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Abstract

Introduction

Though associated meniscus and/or knee ligament injuries following lateral tibial plateau fractures (TPF) are common, the importance of development in gait recovery is unknown. This study aim to report the 12- and 36-month gait recovery in patients with lateral TPF divided into two groups presenting with and without associated meniscus and/or knee ligament injuries. (Associated meniscus and/or knee ligament injuries were grouped as: 1) missing, 2) lateral or medial menisci, 2) posterior and anterior cruciate ligament (PCL/ACL), and 4) lateral or medial collateral ligament.)

Hypothesis

Comparable results at the 12- and 36-month follow-up between groups presenting with and without soft tissue injuries.

Patients and methods

Study design: cohort study. Included were patients admitted following a lateral TPF (AO-type 41 B) between December 1, 2013 and November 30, 2016. The primary outcome score was gait sample.

Results

Fifty-six patients were included. The mean age of the patients at the time of fracture was 56 years (range from 22 to 86). Female gender represents 75%. MRI-verified associated meniscus and/or knee ligament injuries were observed in 28 patients (50%). The average gait speed at the 12- and 36-month follow-up were 125.7 (SD31.3) and 127.7 (SD16.6) cm/sec. for patients with associated meniscus and/or knee ligament injuries and 125.2 (SD31.1) and 130.1 (SD15.6) cm/sec. for patients without associated meniscus and/or knee ligament injuries (p=0.96, p=0.17). Regardless of soft tissue injuries, the development in percent of gait asymmetry for step-length and single-support decrease significantly between the 12- and the 36-month follow-up. (p>0.002)

Discussion

This study indicates that gait recovery following lateral TPFs were not associated with associated meniscus and/or knee ligament injuries at the 12- and 36-month follow-up. Between the 12- and 36-month follow-up asymmetry of the gait function decline significantly indicating a prolonged recovery period of gait function following TPFs.

Level of evidence

II; prospective cohort study.

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Keywords : Menisci and/or knee ligament injury, Gait recovery, Tibial plateau fracture, Gait asymmetry


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© 2023  The Author(s). Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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Vol 109 - N° 5

Articolo 103569- settembre 2023 Ritorno al numero
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