Radiographic and clinical results after surgically treated tibial plateau fractures at three and twenty two years postsurgery.

PURPOSE: We examined the development of osteoarthritis (OA) and post-traumatic bone loss after surgery for tibial plateau fractures (TPF).
METHODS: Patients who had participated in previous follow-up (FU) examinations after TPF and primary reduction and internal fixation were re-evaluated. At the first FU, a median of three years after the accident (short-term FU), the patients underwent functional assessments and standardised X-rays to grade radiological OA and post-traumatic bone loss. At the second FU, a median of 22 years after the accident (long-term FU), 30 patients were available. An identical protocol was applied, and additional investigations [Knee Injury and Osteoarthritis Outcome Score (KOOS) and magnetic resonance imaging (MRI) of the injured knee] were performed.
RESULTS: When the subjective and objective results at first FU were compared with those of the second FU for the same patients, deterioration of symptoms, signs and radiological OA was noted; however, ten patients had no OA even after the long-term FU. Some patients developed post-traumatic bone loss. In 13 of 31 knees, there was little or no radiological evidence of bone loss at the second FU.
CONCLUSIONS: The short-term FU examination results after TPF have little prognostic value for the individual patient, as good results may deteriorate over the long run; however, there were some knees with no OA at the long-term FU. This is the first report focusing on post-traumatic bone loss after TPF.