Endstage arthritis following tibia plateau fractures: average 10-year follow-up

Background: Patients with tibial plateau fractures are believed to have an increased risk for posttraumatic arthritis that may require reconstructive surgery. The incidence of this problem is, however, unknown. We sought to determine the average 10-year incidence of posttraumatic arthritis necessitating reconstructive surgery following tibia plateau fractures. Methods: We used data from our orthopedic trauma database to identify patients with operatively treated tibia plateau fractures. Their cases were cross-referenced with the data from our province's administrative health database and tracked over time for the performance of reconstructive knee surgery. The average follow-up was 10 years. Results: There were 311 tibial plateau fractures treated at our institution between 1987 and 1994. The 10-year Kaplan-Meier survival analysis for the primary outcome of endstage arthritis was 96%. Analysis of the secondary outcome measure, specifically surgeries for what was thought to be "minor arthritis," revealed a 10-year Kaplan-Meier survival of 87%. Conclusion: Our findings may be used to counsel patients who require surgical treatment of tibia plateau fractures about the long-term risk of requiring reconstructive knee surgery for endstage arthritis in the knee.