The influence of arthroscopy on the classification and treatment of tibial plateau fractures

The Science of Variation Group

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Introduction: Arthroscopically-assisted reduction and percutaneous fixation of tibial plateau fractures is associated with fewer adverse events, better knee motion, and better Rasmussen functional scores compared to open reduction internal fixation in a number of non-randomized studies. The purpose of this study was to measure the influence of arthroscopy on the interobserver reliability in classification, treatment, and evaluation of intra-articular pathology and fracture reduction for fractures of the tibial plateau. Methods: Surgeons were invited to participate in this online survey study. Surgeons were randomized at a 1:1 ratio to review eight cases of patients with tibial plateau fractures with either 1) knee radiographs alone or 2) radiographs and arthroscopic images. Multirater kappa was used to assess chance-corrected interobserver agreement. Results: There was no difference in interobserver agreement between groups for classification, treatment choice, determination of intra-articular pathology, or evaluation of fracture reduction. Conclusions: Arthroscopy may not influence classification, treatment choice, diagnosis of intra-articular pathology, or quality of fracture reduction. Future studies will be necessary to determine if arthroscopic-assisted fixation of tibial plateau fractures is generalizable to surgeons of different training backgrounds.

Original languageEnglish (US)
Pages (from-to)520-524
Number of pages5
JournalJournal of Orthopaedics
StatePublished - Nov 1 2020

Bibliographical note

Funding Information:
Althausen P. Appleton P. Babis G.C. Ballas E.G. Balogh Z. Barei D.P. Barquet A. Begue T.C. Beingessner D.M. Bekangero W.D. Biert J. Billow D.G. Bishop J.A. Bloemers F.W. Borris L.C. Brink O. Broekhuyse H. Buckley R. Campbell S.T. Chesser T. Choudhari P. Conflitti J.M. Cross B.J. DeCoster T. Doornberg J.N. Dunbar R.P. Elias N. Firoozabadi R.F. Fras A.R. Frihagen F. Garnavos C. Gehlert R. Geissler J.A. Gillespie J.A. Giordano V. Godoy-Santos A.L. Gomez Gelvez A. Grandi J.E. Haverlag R. Heare A. Henley M.B. Higgins T.F. Hobby J.L. Hsu J.R. Jenkinson R. Jeray K. Kabir K. Kahn K.M. Kanakaris N.K. Kanakaris N.K. Karam M.D. Kleweno C. Kloen P. Klostermann C. Knobe M. Koerner M.R. Kristan A. Lafferty P.M. Lasanianos N.G. Lin C.A. Lund E.A. Marsh I. McCutchan H. Medina C.M. Mica L. Mirck B. Mittlmeier T. Moreta J. Morgan S.J. Mormino M.A. Morris T.R. Munyak J. Nikolaou V.S. Nork S. E. Obremskey W.T. Pesantez R. Peters A. Pfeifer R. Pirpiris M. Platz A. Prayson M. Prkic A. Rodriguez E.K. Roiz J.M. Schandelmaier P. Schepers T. Scolaro J.A. Seibert F.J. Spitler C.A. Spoor A.B. Stojkovska Pemovska E. Streubel P. Swiontkowski M. Taitsman L.A. Talbot M. Tosounidis T. Tyllianakis M. van der Heide H. van Eerten P.V. van Helden S.H. Verbeek D.O. Wascher D.C. Weil Y. Yoon P.


  • Arthroscopic-assisted fixation
  • Arthroscopy
  • Tibial plateau fractures

PubMed: MeSH publication types

  • Journal Article

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