Incidence and recovery of anterior cruciate ligament rupture combined with posterolateral tibial plateau fracture in the East China population: a 2-year follow-up study

Abstract Objective: This study aimed to describe the incidence of ACL ruptures combined with posterolateral tibial plateau fractures in the East China population and evaluate the clinical outcomes of ACL reconstruction without treatment for posterolateral tibial plateau fracture at a 2-year follow-up. Methods: Based on the inclusion criteria, the study included patients with ACL rupture or ACL avulsion fracture. MRI scans were reviewed to determine the incidence of ACL rupture combined with posterolateral tibial plateau fracture and concomitant injury. Clinical outcomes were evaluated using the SF-12 scale, the IKDC Subjective Knee Assessment Scale, the Lysholm Knee Rating Scale, the Tegner Activity Level Scale, and the KOOS score at a 2-year follow-up. Results: 488 cases were enrolled, with 74.6% having noncontact injury mechanisms. Fractures with higher severity had a higher rate of meniscus damage, and patients with high-grade subtypes of fractures had a higher incidence of MCL tears than patients with low-grade fracture types. The Lysholm scores of the high-grade subtypes were 85.45 and 86.37, and the postoperative Tegner scores of the high-grade subtypes were 5.5. There were significant differences in functional recovery between patients with high-grade subtypes and patients with low-grade tibial plateau fractures. Conclusions: The study found a high prevalence of displaced posterolateral tibial plateau impaction fractures in the setting of ACL tears, and they can be classified into distinct morphologic subtypes. The functional recovery of patients with high-grade subtypes of fractures is significantly lower than that of patients with low-grade injuries, suggesting that patients with high-grade injuries need surgical treatment to obtain satisfactory treatment results.