Gait recovery is not associated with meniscus and-or knee ligament injuries following lateral tibial plateau fractures. A prospective 3-year cohort study of 56 patients
Abstract
Introduction: Though associated meniscus and/or knee ligament injuries following lateral tibial plateau fractures (TPF) are common, the importance of development in gait recovery is unknown. This study aim to report the 12- and 36-month gait recovery in patients with lateral TPF divided into two groups presenting with and without associated meniscus and/or knee ligament injuries. (Associated meniscus and/or knee ligament injuries were grouped as: 1) missing, 2) lateral or medial menisci, 2) posterior and anterior cruciate ligament (PCL/ACL), and 4) lateral or medial collateral ligament.)
Hypothesis: Comparable results at the 12- and 36-month follow-up between groups presenting with and without soft tissue injuries.
Patients and Methods: Study design: cohort study. Included were patients admitted following a lateral TPF (AO-type 41 B) between December 1, 2013 and November 30, 2016. The primary outcome score was gait sample.
Results: Fifty-six patients were included. The mean age of the patients at the time of fracture was 56 years (range from 22 to 86). Female gender represents 75%. MRI-verified associated meniscus and/or knee ligament injuries were observed in 28 patients (50%). The average gait speed at the 12- and 36-month follow-up were 125.7 (SD31.3) and 127.7 (SD16.6) cm/sec. for patients with associated meniscus and/or knee ligament injuries and 125.2 (SD31.1) and 130.1 (SD15.6) cm/sec. for patients without associated meniscus and/or knee ligament injuries (P=0.96, P=0.17). Regardless of soft tissue injuries, the development in percent of gait asymmetry for step-length and single-support decrease significantly between the 12- and the 36-month follow-up. (P>0.002)
Discussion: This study indicates that gait recovery following lateral TPFs were not associated with associated meniscus and/or knee ligament injuries at the 12- and 36-month follow-up. Between the 12- and 36-moth follow-up asymmetry of the gait function decline significantly indicating a prolonged recovery period of gait function following TPFs.
Level of evidence: II; prospective cohort study
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