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- Title
Return to Skiing After Tibial Plateau Fracture.
- Authors
O'Neill, Dillon C.; Sato, Eleanor H.; Myhre, Luke A.; Kantor, Adam H.; Rothberg, David L.; Higgins, Thomas F.; Marchand, Lucas S.; Haller, Justin M.
- Abstract
Background: Tibial plateau fractures in skiers are devastating injuries with increasing incidence. Few studies have evaluated patient-reported outcomes and return to skiing after operative fixation of a tibial plateau fracture. Purpose: To (1) identify demographic factors, fracture characteristics, and patient-reported outcome measures that are associated with return to skiing and (2) characterize changes in skiing performance after operative fixation of a tibial plateau fracture. Study Design: Case series; Level of evidence, 4. Methods: We reviewed all operative tibial plateau fractures performed between 2016 and 2021 at a single level-1 trauma center. Patients with a minimum of 10-month follow-up data were included. Patients who self-identified as skiers or were injured skiing were divided into those who returned to skiing and those who did not postoperatively. Patients were contacted to complete the Patient-Reported Outcomes Measurement Information System–Physical Function domain (PROMIS-PF), the Knee injury and Osteoarthritis Outcome Score–Activities of Living (KOOS-ADL), and a custom return-to-skiing questionnaire. Multivariate logistic regression was performed with sex, injury while skiing, PROMIS-PF, and KOOS-ADL as covariates to evaluate factors predictive of return to skiing. Results: A total of 90 skiers with a mean follow-up of 3.4 ± 1.5 years were included in the analysis. The rate of return to skiing was 45.6% (n = 41). The return cohort was significantly more likely to be men (66% vs 41%; P =.018) and injured while skiing (63% vs 39%; P =.020). In the return cohort, 51.2% returned to skiing 12 months postoperatively. The percentage of patients who self-reported skiing on expert terrain dropped by half from pre- to postinjury (61% vs 29.3%, respectively). Only 78% of return skiers had regained comfort with skiing at the final follow-up. Most patients (65%) felt the hardest aspect of returning to skiing was psychological. In the multivariate regression, the male sex and KOOS-ADL independently predicted return to skiing (P =.006 and P =.028, respectively). Conclusion: Fewer than half of skiers who underwent operative fixation of a tibial plateau fracture could return to skiing at a mean 3-year follow-up. The knee-specific KOOS-ADL outperformed the global PROMIS-PF in predicting a return to skiing.
- Subjects
SPORTS participation; TRAUMA centers; MULTIPLE regression analysis; TIBIAL plateau fractures; HEALTH outcome assessment; POSTOPERATIVE care; MANN Whitney U Test; T-test (Statistics); QUESTIONNAIRES; DESCRIPTIVE statistics; CHI-squared test; ATHLETIC ability; COMPUTED tomography; SKIING
- Publication
Orthopaedic Journal of Sports Medicine, 2023, Vol 11, Issue 10, p1
- ISSN
2325-9671
- Publication type
Article
- DOI
10.1177/23259671231205925