Initial and Residual 3D Fracture Displacement Is Predictive for Patient-Reported Functional Outcome at Mid-Term Follow-Up in Surgically Treated Tibial Plateau Fractures
Background: Conventional measures of fracture displacement have low interobserver reliability. This study introduced a novel 3D method to measure tibial plateau fracture displacement and its impact on functional outcome. Methods: A multicentre study was conducted on patients who had tibial plateau f...
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MDPI AG
2023-09-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/18/6055 |
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| author | Nick Assink Eelke Bosma Anne M. L. Meesters Sven H. van Helden Robert J. Nijveldt Kaj ten Duis Max J. H. Witjes Jean-Paul P. M. de Vries Joep Kraeima Frank F. A. IJpma |
| author_facet | Nick Assink Eelke Bosma Anne M. L. Meesters Sven H. van Helden Robert J. Nijveldt Kaj ten Duis Max J. H. Witjes Jean-Paul P. M. de Vries Joep Kraeima Frank F. A. IJpma |
| author_sort | Nick Assink |
| collection | DOAJ |
| description | Background: Conventional measures of fracture displacement have low interobserver reliability. This study introduced a novel 3D method to measure tibial plateau fracture displacement and its impact on functional outcome. Methods: A multicentre study was conducted on patients who had tibial plateau fracture surgery between 2003 and 2018. Eligible patients had a preoperative CT scan (slice thickness ≤ 1 mm) and received a Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire. A total of 362 patients responded (57%), and assessment of initial and residual fracture displacement was performed via measurement using the 3D gap area (mm<sup>2</sup>). Patients were divided into four groups based on the 3D gap area size. Differences in functional outcome between these groups were assessed using analysis of variance (ANOVA). Multiple linear regression was used to determine the association between fracture displacement and patient-reported outcome. Results: Functional outcome appeared significantly worse when initial or residual fracture displacement increased. Multivariate linear regression showed that initial 3D gap area (per 100 mm<sup>2</sup>) was significantly negatively associated with all KOOS subscales: symptoms (−0.9, <i>p</i> < 0.001), pain (−0.0, <i>p</i> < 0.001), ADL (−0.8, <i>p</i> = 0.002), sport (−1.4, <i>p</i> < 0.001), and QoL (−1.1, <i>p</i> < 0.001). In addition, residual gap area was significantly negatively associated with the subscales symptoms (−2.2, <i>p</i> = 0.011), ADL (−2.2, <i>p</i> = 0.014), sport (−2.6, <i>p</i> = 0.033), and QoL (−2.4, <i>p</i> = 0.023). Conclusion: A novel 3D measurement method was applied to quantify initial and residual displacement. This is the first study which can reliably classify the degree of displacement and indicates that increasing displacement results in poorer patient-reported functional outcomes. |
| first_indexed | 2024-03-10T22:36:52Z |
| format | Article |
| id | doaj.art-0f6bf923e65a4ed3b0bd9e05d811722e |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T22:36:52Z |
| publishDate | 2023-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-0f6bf923e65a4ed3b0bd9e05d811722e2023-11-19T11:21:08ZengMDPI AGJournal of Clinical Medicine2077-03832023-09-011218605510.3390/jcm12186055Initial and Residual 3D Fracture Displacement Is Predictive for Patient-Reported Functional Outcome at Mid-Term Follow-Up in Surgically Treated Tibial Plateau FracturesNick Assink0Eelke Bosma1Anne M. L. Meesters2Sven H. van Helden3Robert J. Nijveldt4Kaj ten Duis5Max J. H. Witjes6Jean-Paul P. M. de Vries7Joep Kraeima8Frank F. A. IJpma9Department of Trauma Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Trauma Surgery, Martini Hospital, 9712 CP Groningen, The NetherlandsDepartment of Trauma Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Trauma Surgery, Isala Hospital, 8025 AB Zwolle, The NetherlandsDepartment of Trauma Surgery, Isala Hospital, 8025 AB Zwolle, The NetherlandsDepartment of Trauma Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands3D Lab, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Surgery, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands3D Lab, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Trauma Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The NetherlandsBackground: Conventional measures of fracture displacement have low interobserver reliability. This study introduced a novel 3D method to measure tibial plateau fracture displacement and its impact on functional outcome. Methods: A multicentre study was conducted on patients who had tibial plateau fracture surgery between 2003 and 2018. Eligible patients had a preoperative CT scan (slice thickness ≤ 1 mm) and received a Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire. A total of 362 patients responded (57%), and assessment of initial and residual fracture displacement was performed via measurement using the 3D gap area (mm<sup>2</sup>). Patients were divided into four groups based on the 3D gap area size. Differences in functional outcome between these groups were assessed using analysis of variance (ANOVA). Multiple linear regression was used to determine the association between fracture displacement and patient-reported outcome. Results: Functional outcome appeared significantly worse when initial or residual fracture displacement increased. Multivariate linear regression showed that initial 3D gap area (per 100 mm<sup>2</sup>) was significantly negatively associated with all KOOS subscales: symptoms (−0.9, <i>p</i> < 0.001), pain (−0.0, <i>p</i> < 0.001), ADL (−0.8, <i>p</i> = 0.002), sport (−1.4, <i>p</i> < 0.001), and QoL (−1.1, <i>p</i> < 0.001). In addition, residual gap area was significantly negatively associated with the subscales symptoms (−2.2, <i>p</i> = 0.011), ADL (−2.2, <i>p</i> = 0.014), sport (−2.6, <i>p</i> = 0.033), and QoL (−2.4, <i>p</i> = 0.023). Conclusion: A novel 3D measurement method was applied to quantify initial and residual displacement. This is the first study which can reliably classify the degree of displacement and indicates that increasing displacement results in poorer patient-reported functional outcomes.https://www.mdpi.com/2077-0383/12/18/6055tibial plateau fracturethree-dimensional3DQ3DCTpatient-reported outcomeKOOS |
| spellingShingle | Nick Assink Eelke Bosma Anne M. L. Meesters Sven H. van Helden Robert J. Nijveldt Kaj ten Duis Max J. H. Witjes Jean-Paul P. M. de Vries Joep Kraeima Frank F. A. IJpma Initial and Residual 3D Fracture Displacement Is Predictive for Patient-Reported Functional Outcome at Mid-Term Follow-Up in Surgically Treated Tibial Plateau Fractures Journal of Clinical Medicine tibial plateau fracture three-dimensional 3D Q3DCT patient-reported outcome KOOS |
| title | Initial and Residual 3D Fracture Displacement Is Predictive for Patient-Reported Functional Outcome at Mid-Term Follow-Up in Surgically Treated Tibial Plateau Fractures |
| title_full | Initial and Residual 3D Fracture Displacement Is Predictive for Patient-Reported Functional Outcome at Mid-Term Follow-Up in Surgically Treated Tibial Plateau Fractures |
| title_fullStr | Initial and Residual 3D Fracture Displacement Is Predictive for Patient-Reported Functional Outcome at Mid-Term Follow-Up in Surgically Treated Tibial Plateau Fractures |
| title_full_unstemmed | Initial and Residual 3D Fracture Displacement Is Predictive for Patient-Reported Functional Outcome at Mid-Term Follow-Up in Surgically Treated Tibial Plateau Fractures |
| title_short | Initial and Residual 3D Fracture Displacement Is Predictive for Patient-Reported Functional Outcome at Mid-Term Follow-Up in Surgically Treated Tibial Plateau Fractures |
| title_sort | initial and residual 3d fracture displacement is predictive for patient reported functional outcome at mid term follow up in surgically treated tibial plateau fractures |
| topic | tibial plateau fracture three-dimensional 3D Q3DCT patient-reported outcome KOOS |
| url | https://www.mdpi.com/2077-0383/12/18/6055 |
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