Long-term Outcomes of Tibial Spine Avulsion Fractures After Open Reduction With Osteosuturing Versus Arthroscopic Screw Fixation: A Multicenter Comparative Study.

Autor:	Jääskelä M; Department of Pediatric Orthopaedics and Surgery, Oulu University Hospital; Research Unit of Clinical Medicine, University of Oulu; and Medical Research Center, Oulu, Finland., Turati M; Orthopedic Department, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.; Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.; Ripoll y De Prado FIFA Medical Centre of Excellence, Madrid, Spain., Lempainen L; Ripoll y De Prado FIFA Medical Centre of Excellence, Madrid, Spain.; FinnOrthopaedics/Hospital Pihlajalinna, Turku, Finland.; Department of Physical Activity and Health, Paavo Nurmi Centre, University of Turku, Turku, Finland., Bremond N; Transalpine Center of Pediatric Sports Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.; Department of Paediatric Orthopaedic Surgery, Hospital Couple Enfant, Grenoble Alpes University, Grenoble, France., Courvoisier A; Transalpine Center of Pediatric Sports Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.; Department of Paediatric Orthopaedic Surgery, Hospital Couple Enfant, Grenoble Alpes University, Grenoble, France., Henri A; Unité de Médecine du Sport, Centre Hospitalier Francois Mitterand de Pau, Pau, France., Accadbled F; Department of Orthopaedic Surgery, Hôpital des Enfants, Centre Hospitalier Universitaire de Toulouse, Toulouse, France., Sinikumpu J; Department of Pediatric Orthopaedics and Surgery, Oulu University Hospital; Research Unit of Clinical Medicine, University of Oulu; and Medical Research Center, Oulu, Finland.; Hospital TerveysTalo, Oulu, Finland.
Jazyk:	angličtina
Zdroj:	Orthopaedic journal of sports medicine [Orthop J Sports Med] 2023 Jun 20; Vol. 11 (6), pp. 23259671231176991. Date of Electronic Publication: 2023 Jun 20 (Print Publication: 2023).
DOI:	10.1177/23259671231176991
Abstrakt:	Background: More information is needed regarding return to preinjury sport levels and patient-reported outcomes after tibial spine avulsion (TSA) fracture, which is most common in children aged 8 to 12 years. Purpose: To analyze return to play/sport (RTP), subjective knee-specific recovery, and quality of life in patients after TSA fracture treated with open reduction with osteosuturing versus arthroscopic reduction with internal screw fixation. Study Design: Cohort study; Level of evidence, 3. Methods: This study included 61 patients <16 years old with TSA fracture treated via open reduction with osteosuturing (n = 32) or arthroscopic reduction with screw fixation (n = 29) at 4 institutions between 2000 and 2018; all patients had at least 24 months of follow-up (mean ± SD, 87.0 ± 47.1 months; range, 24-189 months). The patients completed questionnaires regarding ability to return to preinjury-level sports, subjective knee-specific recovery, and health-related quality of life, and results were compared between treatment groups. Univariate and multivariate logistic regression analyses were conducted to determine variables associated with failure to return to preinjury level of sport. Results: The mean patient age was 11 years, with a slight male predominance (57%). Open reduction with osteosuturing was associated with a quicker RTP time than arthroscopy with screw implantation (median, 8.0 vs 21.0 weeks; P < .001). Open reduction with osteosuturing was also associated with a lower risk of failure to RTP at preinjury level (adjusted odds ratio, 6.4; 95% CI, 1.1-36.0; P = .035). Postoperative displacement >3 mm increased the risk of failure to RTP at preinjury level regardless of treatment group (adjusted odds ratio, 15.2; 95% CI, 1.2-194.9; P = .037). There was no difference in knee-specific recovery or quality of life between the treatment groups. Conclusion: Open surgery with osteosuturing was a more viable option for treating TSA fractures because it resulted in a quicker RTP time and a lower rate of failure to RTP as compared with arthroscopic screw fixation. Precise reduction contributed to improved RTP. Competing Interests: The authors have declared that there are no conflicts of interest in the authorship and publication of this contribution. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto. (© The Author(s) 2023.)
Databáze:	MEDLINE
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