Background

The goal of postoperative tibial plateau fracture (TPF) management is to ensure surgical fixation is maintained while returning patients to normal function as soon as possible, allowing patients to resume their normal activities of daily living. The aim of this study was to investigate longitudinal changes in lower limb joint kinematics following TPF and determine how these kinematics relate to self-reported function.

Methods

Patients presenting with a TPF were recruited (n = 18) and undertook gait analysis at six postoperative time points (two weeks, six weeks, three months, six months, one and two years). Lower limb joint kinematics were assessed at each time point based on gait data. Statistical parametric mapping (SPM) was undertaken to investigate the change in joint kinematic traces with time. The Knee Injury and Osteoarthritis Outcome Score (KOOS) was assessed at each time point to obtain self-reported outcomes. A healthy reference was also analyzed and used for qualitative comparison of joint kinematics.

Results and significance

Knee kinematics showed improvements with time, however only minor changes were noted after six weeks at the hip, and six months at the knee and ankle relative to two weeks postoperative. SPM identified significant improvements with time in hip (p < 0.001) and knee (p = 0.003) flexion. No significant changes were observed with time at the ankle however, when compared to the healthy reference, participants showed reduced plantarflexion at two years. Lower limb joint ROM showed significant weak to moderate correlation with the ADL sub-scale of the KOOS (hip r = 0.442, knee r = 0.303, ankle r = 0.367). The lack of significant changes with time and overall reduced plantarflexion at the ankle potentially reduces propulsive capacity during gait up to two years postoperative. In this study, we see a deficiency in joint kinematics in TPF patients up to two years when compared to a healthy reference, especially at the ankle.

中文翻译：

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胫骨平台骨折术后下肢关节运动学：一项为期2年的纵向研究

背景

术后胫骨平台骨折（TPF）管理的目标是确保维持外科手术固定，同时使患者尽快恢复正常功能，使患者恢复正常的日常生活。这项研究的目的是调查TPF后下肢关节运动学的纵向变化，并确定这些运动学与自我报告功能之间的关系。

方法

招募有TPF的患者（n = 18）并在六个术后时间点（两周，六周，三个月，六个月，一年和两年）进行步态分析。根据步态数据在每个时间点评估下肢关节运动学。进行统计参数映射（SPM）以研究关节运动轨迹随时间的变化。在每个时间点评估膝关节损伤和骨关节炎结果评分（KOOS），以获得自我报告的结果。还分析了健康参考，并将其用于关节运动学的定性比较。

结果与意义

膝关节运动学随着时间的推移而有所改善，但是相对于术后两周，髋关节在六个星期后以及膝盖和脚踝在六个月后仅观察到微小的变化。SPM发现髋关节屈曲时间（p <0.001）和膝关节屈曲时间（p = 0.003）有显着改善。没有观察到脚踝随时间的显着变化，但是，与健康参考相比，参与者在两年内表现出足底屈曲减少。下肢关节ROM与KOOS的ADL子量表具有显着的弱到中度相关性（髋关节r = 0.442，膝关节r = 0.303，踝关节r = 0.367）。缺乏随时间的显着变化以及脚踝的足底屈曲总体降低可能会降低步态直至术后两年的推进能力。在这个研究中，