Trauma: Condromalacia después de los hundimientos de meseta tibial

Second-look arthroscopy after surgical treatment of Schatzker type II plateau fractures through the lateral submeniscal approach.
Lee HJ, Jung HJ, Chang EC, Lee JS, Jung HS.
Arch Orthop Trauma Surg. 2014 Apr;134(4):495-9

Abstract

MAIN PROBLEM:
To evaluate cartilage healing using second-look arthroscopic examination in tibia plateau fracture patients who have undergone open reduction and internal fixation with a submeniscal approach technique.

METHODS:
Between January 2007 and January 2010, we used second-look arthroscopy during 18-24-month follow-up of 20 patients with Schatzkar type II tibial plateau fractures who had undergone open reduction and internal fixation with a submeniscal approach technique. We classified patients according to step-off, knee range of motion, and Knee Society Score, and compared the results with those obtained by arthroscopy.

RESULTS:
Radiologically, 16 cases (80 %) were reduced within 2 mm of step-off. In 11 of these cases, according to the Outerbridge classification, we checked for chondromalacia from grade II to III. We observed 2 mm of step-off in four cases, and each had chondromalacia of at least grade III. The Knee Society Score was associated with chondromalacia grade (p < 0.05).

CONCLUSION:
Even in patients with normal joint range of motion and good clinical and radiological results, the actual condition of the articular cartilage varied significantly. Therefore, more long-term and regular follow-up is needed for proximal plateau fractures.