The effects of injury to the articular cartilage sustained during articular fracture and the effect of treatment interventions on joint function and preservation are poorly understood. Surgeons do not have good data on which to base treatment decisions, and widely held beliefs are not always supported by data. Which fractures benefit from surgery to restore the articular surface? To what degree does the articular surface need to be reduced to predict a favorable outcome? How can we accurately assess the amount of displacement? What is the effect of the articular injury compared with residual displacement on the eventual outcome? These questions were addressed at a symposium presented at the Annual Meeting of the American Orthopaedic Association in June 2001. The evidence to answer the question that was raised in the title of the symposium-Does an anatomic reduction really change the result?-is not necessarily adequate.
The purpose of the symposium, on which this article is based, was to explore the current state of our knowledge of basic and clinical research on articular fractures. In the process, important unanswered questions were identified and an agenda for meaningful research was developed. To accomplish these goals, the basic-science studies on articular cartilage injury, incongruity, and the capacity for remodeling were reviewed. The ability to accurately measure the articular reduction, which is critical to clinical research, was assessed, and clinical data for four representative articular fractures-those of the tibial plateau, acetabulum, distal aspect of the radius, and tibial plafond-are described. Together the data on these four fractures fairly represent what generally is and is not known about outcomes of articular fractures. The data challenge the widely held assumption that the quality of the reduction is closely associated with the outcome. Areas requiring additional research are defined.
### Effects of Articular Injury
On the basis of the type of tissue damage, …
Copyright remains with the authors and publisher.
The effects of injury to the articular cartilage sustained during articular fracture and the effect of treatment interventions on joint function and preservation are poorly understood. Surgeons do not have good data on which to base treatment decisions, and widely held beliefs are not always supported by data. Which fractures benefit from surgery to restore the articular surface? To what degree does the articular surface need to be reduced to predict a favorable outcome? How can we accurately assess the amount of displacement? What is the effect of the articular injury compared with residual displacement on the eventual outcome? These questions were addressed at a symposium presented at the Annual Meeting of the American Orthopaedic Association in June 2001. The evidence to answer the question that was raised in the title of the symposium-Does an anatomic reduction really change the result?-is not necessarily adequate.
The purpose of the symposium, on which this article is based, was to explore the current state of our knowledge of basic and clinical research on articular fractures. In the process, important unanswered questions were identified and an agenda for meaningful research was developed. To accomplish these goals, the basic-science studies on articular cartilage injury, incongruity, and the capacity for remodeling were reviewed. The ability to accurately measure the articular reduction, which is critical to clinical research, was assessed, and clinical data for four representative articular fractures-those of the tibial plateau, acetabulum, distal aspect of the radius, and tibial plafond-are described. Together the data on these four fractures fairly represent what generally is and is not known about outcomes of articular fractures. The data challenge the widely held assumption that the quality of the reduction is closely associated with the outcome. Areas requiring additional research are defined.
### Effects of Articular Injury
On the basis of the type of tissue damage, …
Copyright remains with the authors and publisher.