Proefschrift

Patient-reported quality of life and pain after PWB in surgically treated tibial plateau fractures 77 Patient outcome No significant differences were found in the incidence of postoperative complications between the PWB gƌŽƵƉ ĂŶĚ ƚŚĞ Zt ŐƌŽƵƉ͕ ǀĂůƵĞƐ ŽĨ ǁŚŝĐŚ ǁĞƌĞ ϲ͘ϱй ;EсϮͿ ǀĞƌƐƵƐ ϭϬ͘Ϭй ;EсϲͿ ƌĞƐƉĞĐƚŝǀĞůLJ͘ /Ŷ ƚŚĞ Wt ŐƌŽƵƉ͘ dŚĞ ĐŽŵƉůŝĐĂƚŝŽŶƐ ŝŶ ƚŚĞ Wt ŐƌŽƵƉ ĐŽŶƐŝƐƚĞĚ ŽĨ Eсϭ ŶŽŶ-ƵŶŝŽŶ ĂŶĚ Eсϭ ƐƵƉĞƌĨŝĐŝĂů ǁŽƵŶĚ ŝŶĨĞĐƚŝŽŶ͘ /ƚ ƐŚŽƵůĚ ďĞ ŶŽƚĞĚ͕ however, that both patients started full weight bearing after the postoperative ĐŽŵƉůŝĐĂƚŝŽŶ͘ dŚĞ ĐŽŵƉůŝĐĂƚŝŽŶƐ ŝŶ ƚŚĞ Zt ŐƌŽƵƉ ĐŽŶƐŝƐƚĞĚ ŽĨ Eсϯ ŶŽŶ-ƵŶŝŽŶƐ͕ EсϮ ƐƵƉĞƌĨŝĐŝĂů ǁŽƵŶĚ ŝŶĨĞĐƚŝŽŶƐ ĂŶĚ Eсϭ ĚĞĞƉ ŝŶĨĞĐƚŝŽŶ͘ &ƵƌƚŚĞƌŵŽƌĞ͕ ŶŽ ƐŝŐŶŝĨŝĐĂŶƚ differences between the PWB group and RWB group were found regarding either the postoperative removal of osteosynthesis material or the number of total knee prostheses (Table 6.5). Table 6.5 Patient outcome measurements in the PWB and RWB groups. PWB (N=31) RWB (N=60) Total (N=91) p Total postoperative complications 2 (6.5%) 6 (10.0%) 8 (8.8%) 0.58 Postoperative ROSM ϳ ;ϮϮ͘ϲйͿ Ϯϰ ;ϰϬ͘ϬйͿ ϯϭ ;ϯϰ͘ϭйͿ 0.10 Postoperative TKP 5 (16.1%) 5 (8.3%) 10 (11.0%) Ϭ͘Ϯϳ Discussion This retrospective cohort study found that the use of a PWB protocol for patients with a surgically treated tibial plateau fracture was associated with reduced time to full weight bearing, while similar quality of life, pain and postoperative complication rates were found, compared to RWB. Furthermore, no significant differences were found in rates of postoperative removal of osteosynthesis material or the need for total knee prostheses after tibial plateau fractures. In our study 28.3% of patients in the RWB were already bearing full weight within 12 weeks, highlighting the contrast to the standard protocol of 12 weeks non-weight bearing. The patients in the PWB group were already bearing full weight 6 weeks earlier than the RWB group. In addition, earlier studies reported that one third of the patients do not (fully) comply to a non- or limited weight bearing regimen.ϰ͕ϱ A number of studies found patients to exceed the prescribed amount of partial weight bearing even when self-reported compliance was high.23 Despite the willingness to comply, patients often do not follow the restrictions in weight bearing and advance their weight bearing as fracture healing progresses.

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