Orthopaedics & traumatology, surgery & research : OTSR · 2026
Predictive factors for early revision surgery after tibial plateau fracture fixation: a retrospective cohort study.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Mayor Jorge, Schnorbus Cyra Maria, Clausen Jan-Dierk, Aktas Gökmen, Pacha Tarek Omar, Sehmisch Stephan, Winkelmann Marcel
Аннотация
PURPOSE: Tibial plateau fractures are complex injuries with a considerable risk of early revision due to malalignment, infection, or post-traumatic osteoarthritis. This study aimed to identify predictors of early revision surgery and evaluate their clinical utility.
HYPOTHESIS: Specific radiological alignment parameters and clinical factors can predict the need for early revision surgery within 12 months.
METHODS: We retrospectively analyzed 153 patients who underwent surgical fixation for tibial plateau fractures at a Level I trauma center between 2012 and 2022. Radiological assessments included the Rasmussen Score, leg axis deviation, tibial slope, joint line convergence angle (JLCA), and medial proximal tibial angle (MPTA). Logistic regression was performed to identify predictors of revision within 12 months.
RESULTS: Nineteen patients (12.4%) required revision surgery, comprising 10 reosteosynthesis procedures and 9 total knee arthroplasties (TKA). Patients undergoing revision had significantly lower Rasmussen Scores (12 vs. 14, p = 0.007) and greater fracture impression depth (3 mm vs. 2 mm, p = 0.004). No significant differences were found for other radiographic parameters. TKA patients were older (59.8 vs. 48.8 years, p = 0.01) and had higher Charlson Comorbidity Index scores (p = 0.013).
CONCLUSIONS: Patients requiring early conversion to endoprosthesis were older and had greater comorbidity burdens, supporting the ongoing debate about primary arthroplasty in selected cases. While the Rasmussen Score showed limited predictive value, most radiological parameters were not associated with revision risk. Integration of functional outcomes and advanced imaging may refine surgical decision-making in tibial plateau fracture management.
LEVEL OF EVIDENCE: IV, retrospective observational study.
HYPOTHESIS: Specific radiological alignment parameters and clinical factors can predict the need for early revision surgery within 12 months.
METHODS: We retrospectively analyzed 153 patients who underwent surgical fixation for tibial plateau fractures at a Level I trauma center between 2012 and 2022. Radiological assessments included the Rasmussen Score, leg axis deviation, tibial slope, joint line convergence angle (JLCA), and medial proximal tibial angle (MPTA). Logistic regression was performed to identify predictors of revision within 12 months.
RESULTS: Nineteen patients (12.4%) required revision surgery, comprising 10 reosteosynthesis procedures and 9 total knee arthroplasties (TKA). Patients undergoing revision had significantly lower Rasmussen Scores (12 vs. 14, p = 0.007) and greater fracture impression depth (3 mm vs. 2 mm, p = 0.004). No significant differences were found for other radiographic parameters. TKA patients were older (59.8 vs. 48.8 years, p = 0.01) and had higher Charlson Comorbidity Index scores (p = 0.013).
CONCLUSIONS: Patients requiring early conversion to endoprosthesis were older and had greater comorbidity burdens, supporting the ongoing debate about primary arthroplasty in selected cases. While the Rasmussen Score showed limited predictive value, most radiological parameters were not associated with revision risk. Integration of functional outcomes and advanced imaging may refine surgical decision-making in tibial plateau fracture management.
LEVEL OF EVIDENCE: IV, retrospective observational study.