A meta-analysis of the curative effects of minimally invasive treatment under arthroscope versus open reduction and internal fixation for tibial plateau fractures
ZHAO Sen
WEI Xiao-chun
Abstract：Objective To compare the curative effects of minimally invasive treatment under arthroscope versus open reduction and internal ifxation in the treatment of tibial plateau fractures of Schatzker type I-IV. Methods Randomized controlled trials ( RCTs ) at home and abroad were comprehensively searched for comparing the curative effects of minimally invasive treatment under arthroscope versus traditional open reduction and internal ifxation for tibial plateau fractures. According to speciifc inclusion and exclusion criteria, the literatures were selected. The clinical indicators included the excellent and good rate of postoperative Sanders knee function score, incision length, operation time, intraoperative blood loss and anatomical reduction rate. All the data were included in the meta-analysis with RevMan 5.0 software. Results A total of 4 eligible RCTs were included, with 419 cases of tibial plateau fractures in all. There were 205 cases in the arthroscopic reduction and internal ifxation ( ARIF ) group and 214 cases in the open reduction and internal ifxation ( ORIF ) group. The meta-analysis results showed there were statistically signiifcant differences between the 2 groups in the excellent and good rate of postoperative Sanders knee function score [ odds ratio ( OR )=1.78, 95%conifdence interval ( CI ) ( 1.07, 2.97 ), P<0.05 ], incision length [ weighted mean difference ( WMD )=-12.12, 95%CI (-12.69,-11.54 ), P<0.05 ], intraoperative blood loss [ WMD=-61.99, 95%CI (-64.21,-59.78 ), P<0.05 ], anatomical reduction rate [ OR=3.00, 95%CI ( 1.16, 7.75 ), P<0.05 ]. There were no statistically signiifcant differences between the 2 groups in the operation time [ WMD=0.80, 95%CI (-0.64, 2.24 ), P>0.05 ]. Conclusions ARIF is superior to ORIF in the treatment of tibial plateau fractures of Schatzker Type I-IV, with the advantages of minimal invasion, less intraoperative blood loss, high anatomical reduction rate and high excellent and good rate of postoperative knee joint function. However, as to the operation time, obvious advantages could not be noticed in the ARIF group.
Keywords：Tibial plateau fractureFracture ifxationinternalArthroscopeSurgical procedureminimally invasiveIntra-articular fractureMeta-analysis
Publication Date：2014-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 385-389 )