Morbidity and Total Knee Arthroplasty as a Long-Term Sequela of Tibial Plateau Fractures

Background: Tibial plateau fractures comprise a heterogenic group of patients, involving several mechanisms and variability in demographic characteristics. Although short term peri-operative clinical and radiologic outcomes are well described in the literature, long-term prognosis reports are scarce. Hypothesis: Long-term prognosis of Tibial plateau fractures may be correlated with secondary Osteoarthritis (OA) and the need for total knee arthroplasty in rates greater than reported in the current literature, which focuses on short and mid-term prognosis. Methods: 310 patients treated for Tibial plateau fractures, with a follow up period of 10-30 years were attempted contact by mail. They were questioned about their knee function and subsequent surgeries following the index operation. Total knee arthroplasty was defined as the primary endpoint. Results:70 patients had responded. 61 patients were treated surgically primarily with an ORIF, and nine were treated conservatively. The median follow-up period was 211 months (range 121-368). The median Tegner-Lysholm knee function score was 74.5 (IQR 43). 25 patients underwent additional surgery in the injured knee, and 15 patients with inferior Tegner-Lysholm score had TKA. Several distinguished characteristics were found and discussed. Conclusions: Tibial plateau fractures are a heterogenic group of injuries, with a sub-optimal functional outcome and a high prevalence of additional surgeries, in specific, knee arthroplasty.