TY - JOUR
T1 - The influence of arthroscopy on the classification and treatment of tibial plateau fractures
AU - The Science of Variation Group
AU - Tatman, Lauren M.
AU - Kortlever, Joost T.P.
AU - Cunningham, Brian P.
AU - Ring, David
AU - Swiontkowski, Marc F.
N1 - Publisher Copyright:
© 2020 Professor P K Surendran Memorial Education Foundation
PY - 2020/11/1
Y1 - 2020/11/1
N2 - Introduction: Arthroscopically-assisted reduction and percutaneous fixation of tibial plateau fractures is associated with fewer adverse events, better knee motion, and better Rasmussen functional scores compared to open reduction internal fixation in a number of non-randomized studies. The purpose of this study was to measure the influence of arthroscopy on the interobserver reliability in classification, treatment, and evaluation of intra-articular pathology and fracture reduction for fractures of the tibial plateau. Methods: Surgeons were invited to participate in this online survey study. Surgeons were randomized at a 1:1 ratio to review eight cases of patients with tibial plateau fractures with either 1) knee radiographs alone or 2) radiographs and arthroscopic images. Multirater kappa was used to assess chance-corrected interobserver agreement. Results: There was no difference in interobserver agreement between groups for classification, treatment choice, determination of intra-articular pathology, or evaluation of fracture reduction. Conclusions: Arthroscopy may not influence classification, treatment choice, diagnosis of intra-articular pathology, or quality of fracture reduction. Future studies will be necessary to determine if arthroscopic-assisted fixation of tibial plateau fractures is generalizable to surgeons of different training backgrounds.
AB - Introduction: Arthroscopically-assisted reduction and percutaneous fixation of tibial plateau fractures is associated with fewer adverse events, better knee motion, and better Rasmussen functional scores compared to open reduction internal fixation in a number of non-randomized studies. The purpose of this study was to measure the influence of arthroscopy on the interobserver reliability in classification, treatment, and evaluation of intra-articular pathology and fracture reduction for fractures of the tibial plateau. Methods: Surgeons were invited to participate in this online survey study. Surgeons were randomized at a 1:1 ratio to review eight cases of patients with tibial plateau fractures with either 1) knee radiographs alone or 2) radiographs and arthroscopic images. Multirater kappa was used to assess chance-corrected interobserver agreement. Results: There was no difference in interobserver agreement between groups for classification, treatment choice, determination of intra-articular pathology, or evaluation of fracture reduction. Conclusions: Arthroscopy may not influence classification, treatment choice, diagnosis of intra-articular pathology, or quality of fracture reduction. Future studies will be necessary to determine if arthroscopic-assisted fixation of tibial plateau fractures is generalizable to surgeons of different training backgrounds.
KW - Arthroscopic-assisted fixation
KW - Arthroscopy
KW - Tibial plateau fractures
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U2 - 10.1016/j.jor.2020.10.007
DO - 10.1016/j.jor.2020.10.007
M3 - Article
C2 - 33132625
AN - SCOPUS:85093925381
SN - 0972-978X
VL - 22
SP - 520
EP - 524
JO - Journal of Orthopaedics
JF - Journal of Orthopaedics
ER -