Comparison of outcome of ARIF and ORIF in the treatment of tibial plateau fractures.

PURPOSE: The purpose of this study is to explore whether arthroscopically assisted reduction and internal fixation (ARIF) is superior to traditional open reduction and internal fixation (ORIF) in the treatment of tibial plateau fractures.

METHODS: Fifty-seven patients with tibial plateau fractures (Schatzker type I-IV) treated by ARIF or ORIF from 2010 to 2013 were included in this retrospective study. All patients received pre-operative radiographs and CT scans. The patients were divided into two groups (ARIF or ORIF). All had a minimum follow-up of 24 months and an average follow-up of 44.4 months. The clinical and radiographic outcomes were evaluated according to the Rasmussen and KSS scores.

RESULTS: There was no significant difference in KSS score or Rasmussen clinical score between the two groups. The average Rasmussen radiographic score was 14.1 (SD 2.4, range 10-18), for the ARIF group and 14.9 (SD 2.3, range 10-18) for the ORIF group (p < 0.05). Meniscal lesions were found in 12 knees in group ARIF.

CONCLUSIONS: Both ARIF and ORIF yielded satisfactory clinical results for the treatment of Schatzker I-IV tibial plateau fractures. ARIF led to better radiological results than ORIF. Concomitant intra-articular soft tissue lesions are common and can be addressed during ARIF.

LEVEL OF EVIDENCE: III.