Eleanor H Sato, Dillon C O'Neill, Lillia N Steffenson, Luke A Myhre, Thomas F Higgins, David L Rothberg, Lucas S Marchand, Justin M Haller
{"title":"半月板撕裂需要术中修复不影响手术治疗胫骨平台骨折中期患者报告的结果。","authors":"Eleanor H Sato, Dillon C O'Neill, Lillia N Steffenson, Luke A Myhre, Thomas F Higgins, David L Rothberg, Lucas S Marchand, Justin M Haller","doi":"10.1097/BOT.0000000000002724","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Evaluate whether intraoperatively repaired lateral meniscus injuries impact midterm patient-reported outcomes in those undergoing operative fixation of tibial plateau fracture.</p><p><strong>Methods: </strong></p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Level I trauma center.</p><p><strong>Patient selection criteria: </strong>All patients (n = 207) who underwent operative fixation of a tibial plateau fracture from 2016 to 2021 with a minimum of 10-month follow-up.</p><p><strong>Outcome measures and comparisons: </strong>The Patient-Reported Outcomes Measurement Information System Physical Function, Knee Injury and Osteoarthritis Outcome Score, and the PROMIS-Preference health utility score.</p><p><strong>Results: </strong>Overall, 207 patients were included with average follow-up of 2.9 years. Seventy-three patients (35%) underwent intraoperative lateral meniscus repair. Gender, age, body mass index, Charlson comorbidity index, days to surgery, ligamentous knee injury, open fracture, vascular injury, polytraumatic injuries, Schatzker classification, and Orthopaedic Trauma Association classification were not associated with meniscal repair ( P > 0.05). Rates of reoperation (42% vs. 31%, P = 0.11), infection (8% vs. 10%, P = 0.60), return to work (78% vs. 75%, P = 0.73), and subsequent total knee arthroplasty (8% vs. 5%, P = 0.39) were also similar between those who had a meniscal repair and those without a meniscal injury, respectively. There was no difference in Patient-Reported Outcomes Measurement Information System Physical Function (46.3 vs. 45.8, P = 0.707), PROMIS-Preference (0.51 vs. 0.50, P = 0.729), and all Knee Injury and Osteoarthritis Outcome Score domain scores at the final follow-up between those who had a meniscal repair and those without a meniscal injury, respectively.</p><p><strong>Conclusions: </strong>In patients with an operatively treated tibial plateau fracture, the presence of a concomitant intraoperatively identified and repaired lateral meniscal tear results in similar midterm PROMs and complication rates when compared with patients without meniscal injury.</p><p><strong>Level of evidence: </strong>Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":16644,"journal":{"name":"Journal of Orthopaedic Trauma","volume":" ","pages":"109-114"},"PeriodicalIF":1.6000,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Meniscus Tear Requiring Intraoperative Repair Does Not Influence Midterm Patient-Reported Outcomes in Operatively Treated Tibial Plateau Fractures.\",\"authors\":\"Eleanor H Sato, Dillon C O'Neill, Lillia N Steffenson, Luke A Myhre, Thomas F Higgins, David L Rothberg, Lucas S Marchand, Justin M Haller\",\"doi\":\"10.1097/BOT.0000000000002724\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>Evaluate whether intraoperatively repaired lateral meniscus injuries impact midterm patient-reported outcomes in those undergoing operative fixation of tibial plateau fracture.</p><p><strong>Methods: </strong></p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Level I trauma center.</p><p><strong>Patient selection criteria: </strong>All patients (n = 207) who underwent operative fixation of a tibial plateau fracture from 2016 to 2021 with a minimum of 10-month follow-up.</p><p><strong>Outcome measures and comparisons: </strong>The Patient-Reported Outcomes Measurement Information System Physical Function, Knee Injury and Osteoarthritis Outcome Score, and the PROMIS-Preference health utility score.</p><p><strong>Results: </strong>Overall, 207 patients were included with average follow-up of 2.9 years. Seventy-three patients (35%) underwent intraoperative lateral meniscus repair. Gender, age, body mass index, Charlson comorbidity index, days to surgery, ligamentous knee injury, open fracture, vascular injury, polytraumatic injuries, Schatzker classification, and Orthopaedic Trauma Association classification were not associated with meniscal repair ( P > 0.05). Rates of reoperation (42% vs. 31%, P = 0.11), infection (8% vs. 10%, P = 0.60), return to work (78% vs. 75%, P = 0.73), and subsequent total knee arthroplasty (8% vs. 5%, P = 0.39) were also similar between those who had a meniscal repair and those without a meniscal injury, respectively. There was no difference in Patient-Reported Outcomes Measurement Information System Physical Function (46.3 vs. 45.8, P = 0.707), PROMIS-Preference (0.51 vs. 0.50, P = 0.729), and all Knee Injury and Osteoarthritis Outcome Score domain scores at the final follow-up between those who had a meniscal repair and those without a meniscal injury, respectively.</p><p><strong>Conclusions: </strong>In patients with an operatively treated tibial plateau fracture, the presence of a concomitant intraoperatively identified and repaired lateral meniscal tear results in similar midterm PROMs and complication rates when compared with patients without meniscal injury.</p><p><strong>Level of evidence: </strong>Prognostic Level III. 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引用次数: 0
摘要
目的:评价术中修复外侧半月板损伤对胫骨平台骨折手术固定患者中期报告预后的影响。方法:设计:回顾性队列研究。地点:一级创伤中心。患者选择标准:所有2016-2021年间接受胫骨平台骨折手术固定的患者(n=207),至少随访10个月。结果测量和比较:患者报告的结果测量信息系统身体功能(promise - pf)、膝关节损伤和骨关节炎结果评分(oos)和promise - preference (PROPr)健康效用评分。结果:共纳入207例患者,平均随访2.9年。73例(35%)患者接受了术中外侧半月板修复。性别、年龄、体重指数、Charlson合并症指数、手术天数、膝关节韧带损伤、开放性骨折、血管损伤、多创伤性损伤、Schatzker分型、OTA分型与半月板修复无相关性(p>0.05)。半月板修复组和未半月板损伤组的再手术率(42%对31%,p=0.11)、感染率(8%对10%,p=0.60)、复工率(78%对75%,p=0.73)和随后的全膝关节置换术率(8%对5%,p=0.39)也相似。在半月板修复组和未半月板损伤组的最终随访中,promise - pf (46.3 vs 45.8, p=0.707)、promise - preference (PROPr) (0.51 vs 0.50, p=0.729)和所有oos域评分均无差异。结论:在手术治疗的胫骨平台骨折患者中,术中发现并修复的外侧半月板撕裂导致中期PROMs和并发症发生率与没有半月板损伤的患者相似。
Meniscus Tear Requiring Intraoperative Repair Does Not Influence Midterm Patient-Reported Outcomes in Operatively Treated Tibial Plateau Fractures.
Objectives: Evaluate whether intraoperatively repaired lateral meniscus injuries impact midterm patient-reported outcomes in those undergoing operative fixation of tibial plateau fracture.
Methods:
Design: Retrospective cohort study.
Setting: Level I trauma center.
Patient selection criteria: All patients (n = 207) who underwent operative fixation of a tibial plateau fracture from 2016 to 2021 with a minimum of 10-month follow-up.
Outcome measures and comparisons: The Patient-Reported Outcomes Measurement Information System Physical Function, Knee Injury and Osteoarthritis Outcome Score, and the PROMIS-Preference health utility score.
Results: Overall, 207 patients were included with average follow-up of 2.9 years. Seventy-three patients (35%) underwent intraoperative lateral meniscus repair. Gender, age, body mass index, Charlson comorbidity index, days to surgery, ligamentous knee injury, open fracture, vascular injury, polytraumatic injuries, Schatzker classification, and Orthopaedic Trauma Association classification were not associated with meniscal repair ( P > 0.05). Rates of reoperation (42% vs. 31%, P = 0.11), infection (8% vs. 10%, P = 0.60), return to work (78% vs. 75%, P = 0.73), and subsequent total knee arthroplasty (8% vs. 5%, P = 0.39) were also similar between those who had a meniscal repair and those without a meniscal injury, respectively. There was no difference in Patient-Reported Outcomes Measurement Information System Physical Function (46.3 vs. 45.8, P = 0.707), PROMIS-Preference (0.51 vs. 0.50, P = 0.729), and all Knee Injury and Osteoarthritis Outcome Score domain scores at the final follow-up between those who had a meniscal repair and those without a meniscal injury, respectively.
Conclusions: In patients with an operatively treated tibial plateau fracture, the presence of a concomitant intraoperatively identified and repaired lateral meniscal tear results in similar midterm PROMs and complication rates when compared with patients without meniscal injury.
Level of evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
期刊介绍:
Journal of Orthopaedic Trauma is devoted exclusively to the diagnosis and management of hard and soft tissue trauma, including injuries to bone, muscle, ligament, and tendons, as well as spinal cord injuries. Under the guidance of a distinguished international board of editors, the journal provides the most current information on diagnostic techniques, new and improved surgical instruments and procedures, surgical implants and prosthetic devices, bioplastics and biometals; and physical therapy and rehabilitation.