Friday, September 10, 2010

Tibial Plateau Fracture - Factors Affecting Outcomes

Tibial plateau fractures are associated with an increased risk of osteoarthritis. These fractures are intra-articular - the fracture passes through the smooth surface of the joint. After the fracture is healed there is generally an area of irregularity, even a good result is not as smooth as the joint was prior to injury.
With the thousands of steps we take each day any small step in the surface is thought to increase the rate of wear. The result is post traumatic osteoarthritis.

Some areas of the body tolerate intra-articular fractures better than others. Studies have shown that the tibial plateau is more forgiving than some areas. Other factors seem to have a significant say in the development of arthritis.
These include joint stability, the survival of the meniscus, and the presence of angulation at the knee (varus or valgus deformity).
Many people suffering a tibial plateau fracture will go on to need a total knee replacement. If the fracture does not damage any ligamentous structure, the meniscus survives and there is no angulation at the knee, the risk may be modest. Major fractures also damaging supporting soft tissue structure are likely to have a much poorer outcome.

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