• Pieter Pander, Bas Lennart Fransen, Frans Johan Alexander Hagemans, and Lucien Cornelis Marie Keijser.
• CORAL - Centre for Orthopaedic Research Alkmaar, Department of Orthopaedic Surgery, Noordwest Clinics Alkmaar, Wilhelminalaan 12, 1815 JD, Alkmaar, The Netherlands. pieterpander@gmail.com.
• Arch Orthop Trauma Surg. 2023 Mar 1; 143 (3): 126512741265-1274.

BackgroundPosttraumatic osteoarthritis (PTOA) following a tibial plateau fracture (TPF) is a debilitating disease which often affects a young and active patient population for whom good knee function is essential. Frequently, total knee arthroplasty (TKA) is the only surgical option. The aim of this systematic review was to evaluate functional outcome for TKA in PTOA patients, together with several secondary outcome parameters.MethodsA systematic review according to the PRISMA guidelines was conducted. Studies were included that reported on patient-reported outcome measures, range of motion or objective functional analysis after TKA because of PTOA following TPF.ResultsAfter analyzing 105 studies, 5 were included for the final review. In total, 162 patients with a TKA for PTOA were included of whom 125 (77%) were managed operatively for their TPF. All studies reported improvements in functional outcome after TKA, with two studies showing no significant differences between PTOA patients and a matched cohort of primary OA patients. Reported complication and re-intervention rates were higher for TKA patients with PTOA.ConclusionThe results of this review indicate the TKA for PTOA after a TPF provides satisfactory functional outcome, with results similar to those of matched primary OA patients. TKA should, therefore, be considered a viable treatment option to improve function, but both patients and orthopedic surgeons should be aware of the higher complication rates in this patient population.© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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