Delayed but favourable outcome of lateral tibial plateau fracture after screw fixation: A 3-year prospective cohort study of 56 patients

BACKGROUND: Although a large number of studies aimed to investigate the outcome following lateral tibial plateau fractures, the literature includes limited information on mid- to long-term follow up. The primary objective of the present study was to investigate the 3-year development in Knee Injury and Osteoarthritis Outcome Score (KOOS5) of patients with surgically managed lateral tibial plateau fractures.

METHODS: Prospective cohort study. The study includes all patients treated surgically following a lateral tibial plateau fracture (AO-41B) in the period December 2013 to November 2016. The primary outcome measurement was the patient-reported KOOS5 score. Secondary outcome measurements were quality of life, knee osteoarthritis, muscle strength, pain reactions, and gait function.

RESULTS: Fifty-six patients were included. Thirty-nine patients were eligible for the 3-year follow up (70%). The mean age at the time of the 3-year follow up was 58.3 years with a range of 25-89. The 3-year postoperative mean KOOS5 scores were 75.5 (95% confidence interval: 68.6-82.3). Compared with the KOOS5 score at 12-month follow up (61.3), a significant increase was observed (P > 0.001). In comparison with the established KOOS reference population, the study population showed statistically worse KOOS outcomes only for the subscale sport.

CONCLUSIONS: Patient-reported outcome (KOOS5) among patients with a fracture of the lateral tibial plateau increased significantly between the 1-year and 3-year follow ups. In contrast to the 1-year follow up, patients at the 3-year follow up reported results comparable to those of a healthy reference population, excluding the Sport subscale. Guiding the patients in anticipation of a prolonged recovery period is highly important in everyday clinical practice.