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Radiographic Osteoarthritis and Patient-Reported Outcomes One Year Following Tibial Plateau Fracture Surgery
Leonardo Moreno-Degante1, Bernardo Pettet-Ruiz1, Jorge Ponce-de-Léon-Dominguez1
1Department of Orthopedic Surgery and Traumatology, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, MEX.
Cureus
|August 9, 2026
Summary
Nearly one-fifth of patients developed moderate-to-severe osteoarthritis (Kellgren-Lawrence grades 3-4) after tibial plateau fracture surgery, leading to significant functional decline. Early radiographic osteoarthritis, not fracture complexity, predicted poorer outcomes.
Area of Science:
- Orthopedic surgery
- Trauma care
- Radiology
Background:
- Tibial plateau fractures often result from high-energy trauma.
- Surgical treatment aims to restore function and prevent post-traumatic osteoarthritis.
- Predicting long-term outcomes remains challenging.
Purpose of the Study:
- Characterize early clinical, functional, and radiographic outcomes post-tibial plateau fracture surgery.
- Identify predictors of moderate-to-severe post-traumatic knee osteoarthritis (Kellgren-Lawrence grades 3-4) at 12 months.
- Assess the contribution of fracture morphology versus radiographic osteoarthritis severity.
Main Methods:
- Retrospective analysis of prospectively collected data from 106 patients.
- Fracture classification using the Schatzker system.
- 12-month follow-up included Rasmussen scores, Kellgren-Lawrence grading, KOOS, and SF-36 assessments.
Main Results:
- 19.8% of patients had Kellgren-Lawrence grades 3-4 at 12 months.
- Moderate-to-severe osteoarthritis correlated with lower KOOS and SF-36 physical functioning scores.
- Older age and female sex predicted Kellgren-Lawrence grades 3-4; fracture complexity did not.
Conclusions:
- Most patients had satisfactory short-term outcomes, but significant radiographic osteoarthritis developed in a notable proportion.
- Early Kellgren-Lawrence grade 3-4 was the strongest predictor of functional impairment.
- Integrating radiographic grading with patient-reported outcomes is crucial for risk stratification.
