Poor sporting abilities after tibial plateau fractures involving the posterior column: how can we do better?

Abstract

Purpose

Tibial plateau fractures with the involvement of the posterior column are an important prognostic factor towards poor functional outcome. We aimed to assess the sporting abilities postoperatively with special emphasis on the type of sports and sport-specific movements, as well as time needed to resume sports, restricting factors in sports engagement, and patient satisfaction. We aimed to provide prognostic information on return to sports.

Methods

Demographic, clinical and radiological variables were retrospectively collected from 82 multicentric patients between 2014 and 2016. Prospectively, sporting abilities before and after surgery were determined using questionnaires at a mean follow-up of 33 months postoperatively.

Results

Involvement in sports significantly decreased, with only 68.4% of patients resuming sports (p < 0.001). The mean time needed to partially or fully resume sports was 6–9 and 9–12 months, respectively. The ability to resume at the pre-injury level of effort and performance was 22% and 12%, respectively. Restricting factors were pain (66%), fear of re-injury (37%), limited range of motion (26%), and instability (21%). The majority (59%) of patients were unsatisfied with their physical abilities. Significantly worse outcomes were observed in patients playing high-impact sports, experiencing knee pain during physical activity, suffering from extension/valgus or flexion/varus trauma.

Conclusions

Tibial plateau fractures with the involvement of the posterior column significantly hamper the patients’ sporting abilities, leaving the majority of patients unsatisfied. Preoperative counseling about prognosis, setting realistic expectations, optimizing rehabilitation and pain management postoperatively, and advising low-impact sports might improve engagement in physical activities and emotional impact on patients.

Level of evidence

3.

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Correspondence to Harm Hoekstra.

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The authors declare that they have no conflict of interest.

Ethical approval

This study was completed in compliance with national legislation and the guidelines of the Ethische Commissie Onderzoek UZ/KU Leuven, Commissie Medische Ethiek and Medische Ethische Toetsings Commissie Erasmus MC. The rights of the subjects were protected.

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Informed consent was obtained from all individual participants included in the study.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Quintens, L., Van den Berg, J., Reul, M. et al. Poor sporting abilities after tibial plateau fractures involving the posterior column: how can we do better?. Eur J Trauma Emerg Surg 47, 201–209 (2021). https://doi.org/10.1007/s00068-019-01220-3

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Keywords

  • Knee
  • Trauma
  • Fracture
  • Posterior column
  • Physical activity
  • Sports