Factors related with the functional outcome of patients who sustained tibial plateau fractures

Abstract

The aim of this study was to determine factors related with the functional outcome of patients after TPF.A quantitative analytical cross-sectional study of patients after TPF was undertaken. The study sample consisted of 86 patients who sustained TPF between 2015 and 2019 and received conservative or surgical intervention in three public hospitals in the Gauteng province. The KOOS-12 score, was used to determine functional outcome after TPF. The mean KOOS-12 scores indicated significant findings between age groups in KOOS function (p=0.0076) and KOOS pain (p=0.0439) sub-scales. After TPF, the younger age group (20 to 39 years) participants experienced less pain with activities and were more functional in activities of daily living and sport/recreation activities, compared to participants in the older age group (40 to 60 years). The second significant finding was the statistically significant difference between gender in the KOOS-12 QOL (p=0.0102) sub-scale, indicating that female participants had better knee-related quality of life compared to male participants. In the linear analysis prediction of QOL sub-scale in relation to gender, there was a statistically significant difference (p=0.0102) indicating that female participants were the independent predictor of better knee-related quality of life after TPF. Ninety-one percent of patients reported partial to full return to work, while 56% of patients did not return to recreational sporting activities after injury. Three barriers are identified that may affect the attendance of follow-up physiotherapy treatment sessions. Personal finances and social support are barriers that may play a role in how often the patient can return for follow-up sessions. Secondly, the number of outpatient sessions allowed by a health setting (hospital or clinic) may play a role in the final functional outcome of a patient. Because this may result in early discharge before the patient return to pre-injury functional level. Lastly, most of the patients work where they are paid per hour or per day. Attending physiotherapy treatment sessions is time consuming which imply the patient will lose a day’s income. In conclusion, age and gender are personal factors that influence functional outcome after TPF in the current study. It was also observed that participants presented with impairments long after TPF, with limited activity of daily living (ADL), return to vocational activities and participation in recreational activities, thus resulting in poor QOL. The knowledge of contextual and additional factors may help medical professionals to improve a patient’s functional outcome and educate the patient with regard to expected functional outcomes and quality of life (QOL) after TPF. However, these factors are under researched and could benefit from in depth investigation.