University of Oulu

Tapper, V., Toom, A., Pamilo, K. et al. Primary total knee replacement for tibial plateau fractures in older patients: a systematic review of 197 patients. Arch Orthop Trauma Surg 142, 3257–3264 (2022).

Primary total knee replacement for tibial plateau fractures in older patients : a systematic review of 197 patients

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Author: Tapper, V.1; Toom, A.1; Pamilo, K.1;
Organizations: 1Central Finland Hospital, Keskussairaalantie 19, 40620, Jyväskylä, Finland
2Oulu University Hospital, Oulu, Finland
3Coxa Hospital for Joint Replacement, Tampere, Finland
4Tampere University Hospital, Tampere, Finland
5University of Eastern Finland, Kuopio, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.9 MB)
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Language: English
Published: Springer Nature, 2022
Publish Date: 2023-06-19


Introduction: Tibial plateau fractures are typically treated with osteosynthesis. In older patients, osteosynthesis is associated with some complications, risk of post-traumatic osteoarthritis and long partial, or non-weight bearing during the recovery phase. To avoid these problems, primary total knee replacement (TKR) has become an increasingly common treatment option. The aim of this study was to evaluate all the relevant literature and summarize the current evidence-based knowledge on the treatment of tibial plateau fractures with primary TKR in older patients.

Materials and methods: A systematic literature search of studies on total knee replacement (TKR) as primary treatment for acute traumatic tibial plateau fracture was conducted using OVID Medline, Scopus, and Cochrane databases from 1946 to 18 November 2019. We included all studies without restrictions regarding total knee replacement (TKR) as primary treatment for acute traumatic tibial plateau fracture.

Results: Of the 640 reviewed articles, 16 studies with a total of 197 patients met the inclusion criteria. No controlled trials were available, and the overall quality of the literature was low. The results, using different clinical scoring systems, were good or fair. Four-year follow-up complication (6.1%) and revision (3.6%) rates after primary TKR appeared to be lower than after secondary TKR (complication rate 20–48%, revision rate 8–20%) but higher than after elective primary TKR.

Conclusions: Based on low-quality evidence, TKR appears to be a useful treatment option for tibial plateau fractures in older patients. Controlled trials are mandatory to determine the relative superiority of these two options as primary treatment of tibial plateau fractures in older patients.

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Series: Archives of orthopaedic and trauma surgery
ISSN: 0936-8051
ISSN-E: 1434-3916
ISSN-L: 0936-8051
Volume: 142
Issue: 11
Pages: 3257 - 3264
DOI: 10.1007/s00402-021-04150-1
Type of Publication: A2 Review article in a scientific journal
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
Funding: Open access funding provided by University of Eastern Finland (UEF) including Kuopio University Hospital. Päivikki and Sakari Sohlberg Foundation.
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