Gait Characteristics Before Hardware Removal in Patients Operated Upon for Tibial Plateau Fractures

Overview

Journal Int Orthop

Specialty Orthopedics

Date 2015 Feb 13

PMID 25673510

Citations 12

Authors

Bogdan Deleanu

Radu Prejbeanu

Dan Crisan

Vlad Predescu

Iulian Popa

Dan V Poenaru

Affiliations

Soon will be listed here.

Abstract

Purpose: The reporting of gait analysis data on operated fractures of the tibial plateau, while extensive for studies of knee osteoarthritis of mostly undisclosed aetiology and ACL deficient knees, is rather limited in literature.

Methods: In the present study we investigated 25 tibial plateau fractures classified as Schatzker II, IV, V and VI that underwent operative reduction and lateral plate osteosynthesis. Apart from routine radiographic exploration and patient completed (KOOS) scores at three (mean of 3.2 months), six (mean of 5.6 months) and 12 months (mean of 11.3 months) postoperatively, gait analysis was performed at these intervals as well. Cadence, step time and knee flexion were the gait parameters that were selected for the comparison at six and 12 months postoperatively.

Results: The analysed gait parameters were significantly improved between the six and the 12-month session and statistically significant differences were found between the two groups of values. Cadence had a mean value of 41 steps/minute at six months and 45 steps/minute at 12 months (p = 0.99). Step time was a mean of 0.74 seconds at six months while at 12 months the median value was 0.66 seconds (p = 0.94). Knee flexion angles evolved in a similar manner with mean values of 58° at six months and 69° at 12 months (p = 0.95). The mean KOOS scores were 42.4, 56.3 and 67.99 at three, six and 12 months postoperatively, respectively.

Conclusion: Complex intra-articular fractures, classified as Schatzker IV, V and VI, had a higher impact on joint function than Schatzker II fractures treated with similar techniques and implants. There were statistically significant improvements in the recovery status at 12 months postoperatively compared to six months with extended chances for improvement.

Citing Articles

Persistent deficits in knee joint kinematics and kinetics during gait following tibial plateau fractures - a longitudinal study.

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Gait Analysis to Monitor Fracture Healing of the Lower Leg.

Warmerdam E, Orth M, Pohlemann T, Ganse B Bioengineering (Basel). 2023; 10(2).

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Gait biomechanics in patients with intra-articular tibial plateau fractures - gait analysis at three months compared with age- and gender-matched healthy subjects.

Fandriks A, Tranberg R, Karlsson J, Moller M, Zugner R BMC Musculoskelet Disord. 2021; 22(1):702.

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Arthroscopic Repair in Tibial Spine Avulsion Fractures Using Polyethylene Terephthalate Suture: Good to Excellent Results in Pediatric Patients.

Russu O, Pop T, Ciorcila E, Gergely I, Zuh S, Trambitas C J Pers Med. 2021; 11(5).

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Early experience using patient-specific instrumentation in opening wedge high tibial osteotomy.

Predescu V, Grosu A, Gherman I, Prescura C, Hiohi V, Deleanu B Int Orthop. 2021; 45(6):1509-1515.

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References

Chan Y . Arthroscopy- assisted surgery for tibial plateau fractures. Chang Gung Med J. 2011; 34(3):239-47. View

Giannoudis P, Tzioupis C, Papathanassopoulos A, Obakponovwe O, Roberts C . Articular step-off and risk of post-traumatic osteoarthritis. Evidence today. Injury. 2010; 41(10):986-95. DOI: 10.1016/j.injury.2010.08.003. View

Taylor K, Cutcliffe H, Queen R, Utturkar G, Spritzer C, Garrett W . In vivo measurement of ACL length and relative strain during walking. J Biomech. 2012; 46(3):478-83. PMC: 3552116. DOI: 10.1016/j.jbiomech.2012.10.031. View

Grood E, Suntay W . A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. J Biomech Eng. 1983; 105(2):136-44. DOI: 10.1115/1.3138397. View

Bytyqi D, Shabani B, Lustig S, Cheze L, Karahoda Gjurgjeala N, Neyret P . Gait knee kinematic alterations in medial osteoarthritis: three dimensional assessment. Int Orthop. 2014; 38(6):1191-8. PMC: 4037512. DOI: 10.1007/s00264-014-2312-3. View

El Barbary H, Ghani H, Misbah H, Salem K . Complex tibial plateau fractures treated with Ilizarov external fixator with or without minimal internal fixation. Int Orthop. 2005; 29(3):182-5. PMC: 3456886. DOI: 10.1007/s00264-005-0638-6. View

Jansen H, Frey S, Doht S, Fehske K, Meffert R . Medium-term results after complex intra-articular fractures of the tibial plateau. J Orthop Sci. 2013; 18(4):569-77. DOI: 10.1007/s00776-013-0404-3. View

van den Noort J, van der Esch M, Steultjens M, Dekker J, Schepers M, Veltink P . Ambulatory measurement of the knee adduction moment in patients with osteoarthritis of the knee. J Biomech. 2012; 46(1):43-9. DOI: 10.1016/j.jbiomech.2012.09.030. View

Pethes A, Kiss R, Szendroi M . Variability of gait in the early postoperative period of total knee arthroplasty with different surgical technique. Int Orthop. 2013; 38(3):517-23. PMC: 3936104. DOI: 10.1007/s00264-013-2115-y. View

10.

Zhai Q, Hu C, Luo C . Multi-plate reconstruction for severe bicondylar tibial plateau fractures of young adults. Int Orthop. 2013; 38(5):1031-5. PMC: 3997787. DOI: 10.1007/s00264-013-2211-z. View

11.

Mundermann A, Dyrby C, Hurwitz D, Sharma L, Andriacchi T . Potential strategies to reduce medial compartment loading in patients with knee osteoarthritis of varying severity: reduced walking speed. Arthritis Rheum. 2004; 50(4):1172-8. DOI: 10.1002/art.20132. View

12.

Doht S, Lehnert T, Frey S, Fehske K, Jansen H, Blunk T . Effective combination of bone substitute and screws in the jail technique: a biomechanical study of tibial depression fractures. Int Orthop. 2012; 36(10):2121-5. PMC: 3460101. DOI: 10.1007/s00264-012-1604-8. View

13.

Honkonen S, Kannus P, Natri A, Latvala K, Jarvinen M . Isokinetic performance of the thigh muscles after tibial plateau fractures. Int Orthop. 1997; 21(5):323-6. PMC: 3617806. DOI: 10.1007/s002640050177. View

14.

Weigel D, Marsh J . High-energy fractures of the tibial plateau. Knee function after longer follow-up. J Bone Joint Surg Am. 2002; 84(9):1541-51. DOI: 10.2106/00004623-200209000-00006. View

15.

Bejek Z, Paroczai R, Szendroi M, Kiss R . Gait analysis following TKA: comparison of conventional technique, computer-assisted navigation and minimally invasive technique combined with computer-assisted navigation. Knee Surg Sports Traumatol Arthrosc. 2010; 19(2):285-91. DOI: 10.1007/s00167-010-1219-9. View

16.

Bejek Z, Paroczai R, Illyes A, Kiss R . The influence of walking speed on gait parameters in healthy people and in patients with osteoarthritis. Knee Surg Sports Traumatol Arthrosc. 2005; 14(7):612-22. DOI: 10.1007/s00167-005-0005-6. View

17.

Lindeque B, Baldini T . A biomechanical comparison of three different lateral tibia locking plates. Orthopedics. 2010; 33(1):18-21. DOI: 10.3928/01477447-20091124-25. View

18.

Scanlan S, Favre J, Andriacchi T . The relationship between peak knee extension at heel-strike of walking and the location of thickest femoral cartilage in ACL reconstructed and healthy contralateral knees. J Biomech. 2013; 46(5):849-54. DOI: 10.1016/j.jbiomech.2012.12.026. View

19.

Pasa L, Kelbl M, Suchomel R, Prochazka V, Filipinsky J . [Treatment of intra-articular proximal tibial evaluation of two- to seven-year follow-up]. Acta Chir Orthop Traumatol Cech. 2007; 74(5):336-41. View

20.

Amis A . Biomechanics of high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc. 2012; 21(1):197-205. DOI: 10.1007/s00167-012-2122-3. View