[Primary total knee arthroplasty in geriatric patients with tibial plateau fractures]

Fractures around the knee joint are per se challenging to treat, often regardless of the patient's age. Osteosynthesis remains the gold standard for fracture management; however, geriatric patients are often unable to comply with postoperative weight-bearing restrictions on the osteosynthetically treated limb. This can result in a prolonged hospital stay and particularly in aged patients to an increased risk of internal complications. Secondary total knee arthroplasty (TKA) is associated with both higher complication and revision rates compared to primary TKA for acute fractures. The advantage of primary TKA for acute tibial plateau fractures is the possibility for early mobilization with full weight-bearing, even in patients with poor compliance. The aim of primary TKA in treating geriatric tibial plateau fractures is to perform only a single surgery on the injured knee joint (one-shot surgery). Individual patient assessment and an interdisciplinary treatment approach appear to be essential for this specific patient cohort and highlight the importance of primary fracture TKA.