Research progress in treatment of tibial plateau fractures with primary total knee arthroplasty in the elderly / 中华创伤杂志

ABSTRACT

Tibial plateau fractures are intra-articular fractures of the knee.Restoring the articular surface,axis of lower extremities and function of knee is the main goal of treatment.Open reduction and internal fixation remains the gold standard for the treatment.However,it is more difficult to treat fractures in elderly patients with severe osteoarthritis,osteoporosis,and comminuted knee joints.Open reduction and internal fixation are sometimes difficult to achieve the treatment goal,and the patients are prone to bed-related complications.Total knee arthroplasty (TKA) is the main method for the treatment of traumatic arthritis after knee fracture,but the surgery is difficult with multiple complications.At present,some authors have applied primary TKA to the tibial plateau fractures and reported the advantages including immediate post-operative knee stability,early functional exercise and weight-bearing activities,and no need to consider the meniscus retention,cruciate ligament repair and articular anatomical reduction.This article reviews the surgical advantages,surgery-related issues and expenses to discuss the treatment of tibial plateau fractures in the elderly with TKA,providing reference for the treatment of tibial plateau fractures in the elderly.