Free subchondral screws in tibial plateau fractures: do they hinder a total knee arthroplasty? Strategies to prevent complications

B Schuermans, M Reul, P Monteban, W VAN Wijhe, H Vandenneucker, H Hoekstra

Research output: Contribution to journalArticlepeer-review

Abstract

Open reduction and internal fixation of extended lateral column tibial plateau fractures through a tibial condyle osteotomy and limited arthrotomy with the use of free subchondral locking screws is a straightforward and safe technique. However, these free subchondral screws are enclosed in the subchondral bone and therefore virtually impossible to remove after bone healing. The question arises whether these free subchondral screws might hinder a future total knee arthroplasty. In order to refute this, we retrospectively reviewed all surgically managed tibial plateau fractures in our tertiary center during one year and assessed the number, position and configuration of these in situ subchondral screws and K-wires. In addition, we performed a cadaver study, wherein we prepared 7 tibial plateaus for a total knee arthroplasty tibial component placement with free subchondral screws in situ. In this experiment, we demonstrated that free subchondral screws do not interfere with total knee arthroplasty, but they can increase operative time in some cases. We also provide recommendations to avoid difficulties and potential complications.

Original languageEnglish
Pages (from-to)441-448
Number of pages8
JournalActa orthopaedica belgica
Volume89
Issue number3
DOIs
Publication statusPublished - Sept 2023

Bibliographical note

Funding Information:
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. We would like to thank Steven Chow (radiography technician) for his assistance during the cadaver experiments.

Publisher Copyright:
© 2023 ARSMB-KVBMG. All rights reserved.

Keywords

  • Humans
  • Arthroplasty, Replacement, Knee/adverse effects
  • Retrospective Studies
  • Tibial Plateau Fractures
  • Bone Screws
  • Tibial Fractures/surgery
  • Fracture Fixation, Internal/methods

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