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Philippe Neyret - One of the best experts on this subject based on the ideXlab platform.
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Lateral Tibial Plateau autograft in revision surgery for failed medial unicompartmental knee arthroplasty
Knee Surgery Sports Traumatology Arthroscopy, 2017Co-Authors: Simone Cerciello, Sébastien Lustig, Brent J Morris, Enrico Visona, Giuliano Cerciello, Katia Corona, Philippe NeyretAbstract:Purpose Revision surgery for failed unicompartmental knee arthroplasty (UKA) with bone loss is challenging. Several options are available including cement augmentation, metal augmentation, and bone grafting. The aim of the present study was to describe a surgical technique for Lateral Tibial Plateau autografting and report mid-term outcomes.
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Lateral Tibial Plateau autograft in revision surgery for failed medial unicompartmental knee arthroplasty
Knee Surgery Sports Traumatology Arthroscopy, 2017Co-Authors: Simone Cerciello, Sébastien Lustig, Brent J Morris, Enrico Visona, Giuliano Cerciello, Katia Corona, Philippe NeyretAbstract:Revision surgery for failed unicompartmental knee arthroplasty (UKA) with bone loss is challenging. Several options are available including cement augmentation, metal augmentation, and bone grafting. The aim of the present study was to describe a surgical technique for Lateral Tibial Plateau autografting and report mid-term outcomes. Eleven consecutive patients (median age 69.5 years) affected by posteromedial Tibial Plateau collapse after medial UKA were enrolled in the present study. The delay between UKA and revision surgery was 21 months (range 15–36 months). All patients were revised with a cemented posterior-stabilized implant, with a Tibial stem. Medial Tibial Plateau bone loss was treated with an autologous Lateral Tibial Plateau bone graft secured with two absorbable screws. All patients were evaluated with the Oxford Knee Score (OKS), visual analogue scale for pain (VAS), and complete radiographic evaluation. At a median follow-up of 60 months (range 36–84 months), the OKS improved from 21.5 (range 16–26) to 34.5 (range 30–40) (p < 0.01) and the median VAS score improved from 8.0 (range 5–9) to 5.5 (range 3–7) (p < 0.01). No intraoperative complications were recorded. Partial reabsorption of the graft was observed in two cases at final follow-up. Lateral Tibial Plateau bone autograft is an alternative to metal wedge or cement augments in the treatment of medial Plateau collapse after UKA. Primary fixation of the Tibial Plateau autograft can be achieved with absorbable screws and a Tibial-stemmed implant. Further comparative studies with a larger series may be helpful to draw definitive conclusions. Case series, Level IV.
Bengt Mjoberg - One of the best experts on this subject based on the ideXlab platform.
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porous titanium granules are better than autograft bone as a bone void filler in Lateral Tibial Plateau fractures a randomised trial
Journal of Bone and Joint Surgery-british Volume, 2015Co-Authors: Brynjolfur Jonsson, Bengt MjobergAbstract:A total of 20 patients with a depressed fracture of the Lateral Tibial Plateau (Schatzker II or III) who would undergo open reduction and internal fixation were randomised to have the metaphyseal void in the bone filled with either porous titanium granules or autograft bone. Radiographs were undertaken within one week, after six weeks, three months, six months, and after 12 months. The primary outcome measure was recurrent depression of the joint surface: a secondary outcome was the duration of surgery. The risk of recurrent depression of the joint surface was lower (p < 0.001) and the operating time less (p < 0.002) when titanium granules were used. The indication is that it is therefore beneficial to use porous titanium granules than autograft bone to fill the void created by reducing a depressed fracture of the Lateral Tibial Plateau. There is no donor site morbidity, the operating time is shorter and the risk of recurrent depression of the articular surface is less. Cite this article: Bone Joint J 2015; 97-B:836–41
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surgical treatment of depression fractures of the Lateral Tibial Plateau using porous titanium granules
Upsala Journal of Medical Sciences, 2009Co-Authors: Brynjolfur Jonsson, Bengt MjobergAbstract:The clinical and radiological results were excellent in this pilot study of four cases of depression fracture of the Lateral Tibial Plateau, where, in addition to internal fixation with screws or a buttress plate, porous titanium granules were used to support the elevated articular surface.
Peter Stein Larsen - One of the best experts on this subject based on the ideXlab platform.
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delayed but favourable outcome of Lateral Tibial Plateau fracture after screw fixation a 3 year prospective cohort study of 56 patients
Knee, 2021Co-Authors: Rasmus Elsoe, Peter Stein LarsenAbstract:Abstract Background Although a large number of studies aimed to investigate the outcome following Lateral Tibial Plateau fractures, the literature includes limited information on mid- to long-term follow up. The primary objective of the present study was to investigate the 3-year development in Knee Injury and Osteoarthritis Outcome Score (KOOS5) of patients with surgically managed Lateral Tibial Plateau fractures. Methods Prospective cohort study. The study includes all patients treated surgically following a Lateral Tibial Plateau fracture (AO-41B) in the period December 2013 to November 2016. The primary outcome measurement was the patient-reported KOOS5 score. Secondary outcome measurements were quality of life, knee osteoarthritis, muscle strength, pain reactions, and gait function. Results Fifty-six patients were included. Thirty-nine patients were eligible for the 3-year follow up (70%). The mean age at the time of the 3-year follow up was 58.3 years with a range of 25–89. The 3-year postoperative mean KOOS5 scores were 75.5 (95% confidence interval: 68.6–82.3). Compared with the KOOS5 score at 12-month follow up (61.3), a significant increase was observed (P > 0.001). In comparison with the established KOOS reference population, the study population showed statistically worse KOOS outcomes only for the subscale sport. Conclusions Patient-reported outcome (KOOS5) among patients with a fracture of the Lateral Tibial Plateau increased significantly between the 1-year and 3-year follow ups. In contrast to the 1-year follow up, patients at the 3-year follow up reported results comparable to those of a healthy reference population, excluding the Sport subscale. Guiding the patients in anticipation of a prolonged recovery period is highly important in everyday clinical practice.
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presence of magnetic resonance imaging verified soft tissue injuries did not significantly affect the patient reported outcome 12 months following a Lateral Tibial Plateau fracture a 12 month prospective cohort study of 56 patients
Knee, 2020Co-Authors: Rasmus Elsoe, Isa Motahar, Firaz Mahdi, Peter Stein LarsenAbstract:Abstract Background Soft tissue injuries following Lateral Tibial Plateau fracture affect more than half of patients. Regardless of the type of soft tissue injured, it is still unclear how different treatment strategies influence postoperative outcome. The aim of this study was to report the 12-month Knee Injury and Osteoarthritis Outcome Score (KOOS5) of patients with surgically managed Lateral Tibial Plateau fractures divided into groups with and without conservatively managed magnetic resonance imaging (MRI)-verified soft tissue injuries. Methods Prospective cohort study. Patients treated surgically following a Lateral Tibial Plateau fracture (AO-41B) between December 2013 and November 2016 were included. Soft tissue injuries were evaluated with preoperative MRI scans. The primary outcome score was the 12-month KOOS5 score divided into groups with and without soft tissue injuries. Results A total of 56 patients were included. Average patient age was 56 years (range 22–86). Thirty-three patients (59%) were female. Fifty percent of patients presented with MRI-verified soft tissue injuries. At 12 months postoperatively, the mean KOOS5 score for patients with soft tissue injuries was 53.5 (95% confidence interval (CI): 44.8–62.1) and the KOOS5 score for patients without soft tissue injuries was 59.6 (95% CI: 50.7–68.6). No significant difference in the KOOS5 score between patients with and without soft tissue injuries was observed (P = .31). Conclusions At 12-month follow-up the presence of MRI-verified soft tissue injuries did not significantly affect the patient-reported KOOS5 score. More research is needed to investigate the effects of surgical vs. non-surgical treatment strategies of associated soft tissue injuries following Lateral Tibial Plateau fractures.
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the outcome after Lateral Tibial Plateau fracture treated with percutaneus screw fixation show a tendency towards worse functional outcome compared with a reference population
European Journal of Trauma and Emergency Surgery, 2016Co-Authors: Rasmus Elsoe, Peter Stein Larsen, Nitesh Shekhrajka, Luis Sigaard Ferreira, Svend Erik Østgaard, Sten RasmussenAbstract:The objective of this study was to evaluate the functional and radiological outcome after Lateral Tibial Plateau fractures (Muller AO classification (AO) 41-B1, B2 and B3) treated with minimal invasive bone tamp reduction and percutaneous screw fixation. Retrospective, cross-sectional study. Review and clinical examination of 37 patients treated between 2005 and 2010. The patients completed a clinical examination, Knee Injury and Osteoarthritis Outcome Score (KOOS) and questionnaire evaluating QOL (Eq5D-5L). Thirty-seven patients agreed to participate (76 %). Mean time of follow-up was 5.2 years. At final follow-up, maintained anatomical joint reduction was achieved in 34 patients. The mean KOOS score was pain = 84.4, ADL = 88.4, symptoms = 80.7, QOL = 70.3, sport = 59.6. Compared with the established KOOS reference population patients, the current study reports a tendency towards worse KOOS scores but is only significant for KOOS sport. The mean Eq5D-5L index was 0.815 and shows a tendency towards worse outcome compared with the reference population. Mean knee flexion: 125.7° (95–135). A reduced number of sit-to-stands in the mean 30-s chair stand test showed a significant negative association with KOOS. The study showed a significant association between younger age at surgery and worse KOOS outcome. At 5.2-year follow-up, the patients reported a tendency towards worse KOOS and Eq5D-5L scores compared with established reference populations. This study shows a significant association between a decrease in muscle strength and worse KOOS outcome. Furthermore, a significant association between younger age at the time of surgery and worse KOOS outcome score was observed.
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high degree of patient satisfaction after percutaneous treatment of Lateral tibia Plateau fractures
Danish Medical Journal, 2016Co-Authors: Rasmus Elsoe, Peter Stein Larsen, Sten Rasmussen, Hans Ager Hansen, Christian Berre EriksenAbstract:INTRODUCTION: The outcomes and complications following surgical treatment of Tibial Plateau fractures have been widely reported. The objective of this study was to evaluate the quality of life (QoL), functional and radiological outcomes after Lateral Tibial Plateau fractures, Arbeitsgemeinschaft fur Osteosynthesefragen (AO) type 41-B2 and B3, treated with minimally invasive bone tamp reduction, allograft and percutaneous screw fixation. METHODS: This study was a cross-sectional study and a retrospective review and clinical evaluation of patients treated with minimally invasive bone tamp reduction, allograft and percutaneous screw fixation after Lateral Tibial Plateau fractures between 2005 and 2010. The patients completed a clinical examination, Knee Injury and Osteoarthritis Outcome Score (KOOS) and a questionnaire for evaluation of QoL (Eq5D-5L). RESULTS: A total of 28 patients agreed to participate (71%). The mean follow-up time was 2.5 years. Maintained anatomical joint reduction and alignment was achieved in 23 cases. The mean Eq5D-5L index was 0.850. The mean KOOS scores were: pain = 79.9, ADL = 80.8, symptoms = 73.0, QoL = 61.3 and sport = 54.4. Compared with Eq5D-5L reference norms, patients did not report significantly lower scores. Compared with a KOOS reference group, patients reported significantly lower KOOS scores in three subscales. CONCLUSIONS: Tibial Plateau fractures AO type 41-B2 and 41-B3 treated with minimally invasive bone tamp reduction, allograft and percutaneous screw fixation showed a high rate of anatomical reduction (82%), a low rate of complications (3.5%) and a high level of satisfactory patient-reported QoL. FUNDING: none. TRIAL REGISTRATION: not relevant.
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The outcome after Lateral Tibial Plateau fracture treated with percutaneus screw fixation show a tendency towards worse functional outcome compared with a reference population.
European Journal of Trauma and Emergency Surgery, 2015Co-Authors: Rasmus Elsoe, Peter Stein Larsen, Nitesh Shekhrajka, Luis Sigaard Ferreira, Svend Erik Østgaard, Sten RasmussenAbstract:Purpose The objective of this study was to evaluate the functional and radiological outcome after Lateral Tibial Plateau fractures (Muller AO classification (AO) 41-B1, B2 and B3) treated with minimal invasive bone tamp reduction and percutaneous screw fixation.
Rasmus Elsoe - One of the best experts on this subject based on the ideXlab platform.
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delayed but favourable outcome of Lateral Tibial Plateau fracture after screw fixation a 3 year prospective cohort study of 56 patients
Knee, 2021Co-Authors: Rasmus Elsoe, Peter Stein LarsenAbstract:Abstract Background Although a large number of studies aimed to investigate the outcome following Lateral Tibial Plateau fractures, the literature includes limited information on mid- to long-term follow up. The primary objective of the present study was to investigate the 3-year development in Knee Injury and Osteoarthritis Outcome Score (KOOS5) of patients with surgically managed Lateral Tibial Plateau fractures. Methods Prospective cohort study. The study includes all patients treated surgically following a Lateral Tibial Plateau fracture (AO-41B) in the period December 2013 to November 2016. The primary outcome measurement was the patient-reported KOOS5 score. Secondary outcome measurements were quality of life, knee osteoarthritis, muscle strength, pain reactions, and gait function. Results Fifty-six patients were included. Thirty-nine patients were eligible for the 3-year follow up (70%). The mean age at the time of the 3-year follow up was 58.3 years with a range of 25–89. The 3-year postoperative mean KOOS5 scores were 75.5 (95% confidence interval: 68.6–82.3). Compared with the KOOS5 score at 12-month follow up (61.3), a significant increase was observed (P > 0.001). In comparison with the established KOOS reference population, the study population showed statistically worse KOOS outcomes only for the subscale sport. Conclusions Patient-reported outcome (KOOS5) among patients with a fracture of the Lateral Tibial Plateau increased significantly between the 1-year and 3-year follow ups. In contrast to the 1-year follow up, patients at the 3-year follow up reported results comparable to those of a healthy reference population, excluding the Sport subscale. Guiding the patients in anticipation of a prolonged recovery period is highly important in everyday clinical practice.
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presence of magnetic resonance imaging verified soft tissue injuries did not significantly affect the patient reported outcome 12 months following a Lateral Tibial Plateau fracture a 12 month prospective cohort study of 56 patients
Knee, 2020Co-Authors: Rasmus Elsoe, Isa Motahar, Firaz Mahdi, Peter Stein LarsenAbstract:Abstract Background Soft tissue injuries following Lateral Tibial Plateau fracture affect more than half of patients. Regardless of the type of soft tissue injured, it is still unclear how different treatment strategies influence postoperative outcome. The aim of this study was to report the 12-month Knee Injury and Osteoarthritis Outcome Score (KOOS5) of patients with surgically managed Lateral Tibial Plateau fractures divided into groups with and without conservatively managed magnetic resonance imaging (MRI)-verified soft tissue injuries. Methods Prospective cohort study. Patients treated surgically following a Lateral Tibial Plateau fracture (AO-41B) between December 2013 and November 2016 were included. Soft tissue injuries were evaluated with preoperative MRI scans. The primary outcome score was the 12-month KOOS5 score divided into groups with and without soft tissue injuries. Results A total of 56 patients were included. Average patient age was 56 years (range 22–86). Thirty-three patients (59%) were female. Fifty percent of patients presented with MRI-verified soft tissue injuries. At 12 months postoperatively, the mean KOOS5 score for patients with soft tissue injuries was 53.5 (95% confidence interval (CI): 44.8–62.1) and the KOOS5 score for patients without soft tissue injuries was 59.6 (95% CI: 50.7–68.6). No significant difference in the KOOS5 score between patients with and without soft tissue injuries was observed (P = .31). Conclusions At 12-month follow-up the presence of MRI-verified soft tissue injuries did not significantly affect the patient-reported KOOS5 score. More research is needed to investigate the effects of surgical vs. non-surgical treatment strategies of associated soft tissue injuries following Lateral Tibial Plateau fractures.
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the outcome after Lateral Tibial Plateau fracture treated with percutaneus screw fixation show a tendency towards worse functional outcome compared with a reference population
European Journal of Trauma and Emergency Surgery, 2016Co-Authors: Rasmus Elsoe, Peter Stein Larsen, Nitesh Shekhrajka, Luis Sigaard Ferreira, Svend Erik Østgaard, Sten RasmussenAbstract:The objective of this study was to evaluate the functional and radiological outcome after Lateral Tibial Plateau fractures (Muller AO classification (AO) 41-B1, B2 and B3) treated with minimal invasive bone tamp reduction and percutaneous screw fixation. Retrospective, cross-sectional study. Review and clinical examination of 37 patients treated between 2005 and 2010. The patients completed a clinical examination, Knee Injury and Osteoarthritis Outcome Score (KOOS) and questionnaire evaluating QOL (Eq5D-5L). Thirty-seven patients agreed to participate (76 %). Mean time of follow-up was 5.2 years. At final follow-up, maintained anatomical joint reduction was achieved in 34 patients. The mean KOOS score was pain = 84.4, ADL = 88.4, symptoms = 80.7, QOL = 70.3, sport = 59.6. Compared with the established KOOS reference population patients, the current study reports a tendency towards worse KOOS scores but is only significant for KOOS sport. The mean Eq5D-5L index was 0.815 and shows a tendency towards worse outcome compared with the reference population. Mean knee flexion: 125.7° (95–135). A reduced number of sit-to-stands in the mean 30-s chair stand test showed a significant negative association with KOOS. The study showed a significant association between younger age at surgery and worse KOOS outcome. At 5.2-year follow-up, the patients reported a tendency towards worse KOOS and Eq5D-5L scores compared with established reference populations. This study shows a significant association between a decrease in muscle strength and worse KOOS outcome. Furthermore, a significant association between younger age at the time of surgery and worse KOOS outcome score was observed.
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high degree of patient satisfaction after percutaneous treatment of Lateral tibia Plateau fractures
Danish Medical Journal, 2016Co-Authors: Rasmus Elsoe, Peter Stein Larsen, Sten Rasmussen, Hans Ager Hansen, Christian Berre EriksenAbstract:INTRODUCTION: The outcomes and complications following surgical treatment of Tibial Plateau fractures have been widely reported. The objective of this study was to evaluate the quality of life (QoL), functional and radiological outcomes after Lateral Tibial Plateau fractures, Arbeitsgemeinschaft fur Osteosynthesefragen (AO) type 41-B2 and B3, treated with minimally invasive bone tamp reduction, allograft and percutaneous screw fixation. METHODS: This study was a cross-sectional study and a retrospective review and clinical evaluation of patients treated with minimally invasive bone tamp reduction, allograft and percutaneous screw fixation after Lateral Tibial Plateau fractures between 2005 and 2010. The patients completed a clinical examination, Knee Injury and Osteoarthritis Outcome Score (KOOS) and a questionnaire for evaluation of QoL (Eq5D-5L). RESULTS: A total of 28 patients agreed to participate (71%). The mean follow-up time was 2.5 years. Maintained anatomical joint reduction and alignment was achieved in 23 cases. The mean Eq5D-5L index was 0.850. The mean KOOS scores were: pain = 79.9, ADL = 80.8, symptoms = 73.0, QoL = 61.3 and sport = 54.4. Compared with Eq5D-5L reference norms, patients did not report significantly lower scores. Compared with a KOOS reference group, patients reported significantly lower KOOS scores in three subscales. CONCLUSIONS: Tibial Plateau fractures AO type 41-B2 and 41-B3 treated with minimally invasive bone tamp reduction, allograft and percutaneous screw fixation showed a high rate of anatomical reduction (82%), a low rate of complications (3.5%) and a high level of satisfactory patient-reported QoL. FUNDING: none. TRIAL REGISTRATION: not relevant.
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The outcome after Lateral Tibial Plateau fracture treated with percutaneus screw fixation show a tendency towards worse functional outcome compared with a reference population.
European Journal of Trauma and Emergency Surgery, 2015Co-Authors: Rasmus Elsoe, Peter Stein Larsen, Nitesh Shekhrajka, Luis Sigaard Ferreira, Svend Erik Østgaard, Sten RasmussenAbstract:Purpose The objective of this study was to evaluate the functional and radiological outcome after Lateral Tibial Plateau fractures (Muller AO classification (AO) 41-B1, B2 and B3) treated with minimal invasive bone tamp reduction and percutaneous screw fixation.
Simone Cerciello - One of the best experts on this subject based on the ideXlab platform.
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Lateral Tibial Plateau autograft in revision surgery for failed medial unicompartmental knee arthroplasty
Knee Surgery Sports Traumatology Arthroscopy, 2017Co-Authors: Simone Cerciello, Sébastien Lustig, Brent J Morris, Enrico Visona, Giuliano Cerciello, Katia Corona, Philippe NeyretAbstract:Purpose Revision surgery for failed unicompartmental knee arthroplasty (UKA) with bone loss is challenging. Several options are available including cement augmentation, metal augmentation, and bone grafting. The aim of the present study was to describe a surgical technique for Lateral Tibial Plateau autografting and report mid-term outcomes.
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Lateral Tibial Plateau autograft in revision surgery for failed medial unicompartmental knee arthroplasty
Knee Surgery Sports Traumatology Arthroscopy, 2017Co-Authors: Simone Cerciello, Sébastien Lustig, Brent J Morris, Enrico Visona, Giuliano Cerciello, Katia Corona, Philippe NeyretAbstract:Revision surgery for failed unicompartmental knee arthroplasty (UKA) with bone loss is challenging. Several options are available including cement augmentation, metal augmentation, and bone grafting. The aim of the present study was to describe a surgical technique for Lateral Tibial Plateau autografting and report mid-term outcomes. Eleven consecutive patients (median age 69.5 years) affected by posteromedial Tibial Plateau collapse after medial UKA were enrolled in the present study. The delay between UKA and revision surgery was 21 months (range 15–36 months). All patients were revised with a cemented posterior-stabilized implant, with a Tibial stem. Medial Tibial Plateau bone loss was treated with an autologous Lateral Tibial Plateau bone graft secured with two absorbable screws. All patients were evaluated with the Oxford Knee Score (OKS), visual analogue scale for pain (VAS), and complete radiographic evaluation. At a median follow-up of 60 months (range 36–84 months), the OKS improved from 21.5 (range 16–26) to 34.5 (range 30–40) (p < 0.01) and the median VAS score improved from 8.0 (range 5–9) to 5.5 (range 3–7) (p < 0.01). No intraoperative complications were recorded. Partial reabsorption of the graft was observed in two cases at final follow-up. Lateral Tibial Plateau bone autograft is an alternative to metal wedge or cement augments in the treatment of medial Plateau collapse after UKA. Primary fixation of the Tibial Plateau autograft can be achieved with absorbable screws and a Tibial-stemmed implant. Further comparative studies with a larger series may be helpful to draw definitive conclusions. Case series, Level IV.
