Cause and Effect of a Tibial Plateau Fracture on a New Knee JointFractures of the lower leg bone (the tibia) can lead to arthritis of the knee later in life. This is especially true when the break occurs at the upper end of the bone near the knee joint. This area is called the tibial plateau.
Fractures of the tibial plateau can cause problems. If the fracture extends inside the joint, there is a greater risk of early arthritis. A tibial plateau fracture can also cause bone malunion. In a malunion, the bones don't line up exactly during the healing process. The way the patient accepts weight through the leg changes. Arthritis develops faster in such cases.
Many patients with arthritis after tibial plateau fractures end up needing a total knee replacement (TKR). These patients are younger than usual when they get TKR. This situation has its challenges. The authors discuss some of the difficulties during a TKR in a patient with a prior tibial plateau fracture. They point out that the surgeon must use skills, implants, and methods usually needed for complex cases.
Doctors at the Mayo Clinic know that the results of TKR after tibial plateau fractures aren't as good as for TKR patients without a prior fracture. Their study was in agreement with similar studies. Specifically, patients with a previous tibial plateau fracture have more problems after a TKR than those who don't have a prior fracture. The authors list the most common problems: poor healing, joint stiffness, and changes in the way the muscles move the joint.
Nicholas G. Weiss, MD, et al. Total Knee Arthroplasty in Patients With Prior Fracture of the Tibial Plateau. In The Journal of Bone and Joint Surgery. February 2003. Vol. 85-A. No. 2. Pp. 218-221.
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