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Post-traumatic Arthritis of the Proximal Tibia

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Post-Traumatic Arthritis

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Abstract

Symptomatic osteoarthritis (OA) secondary to tibial plateau fractures is a relatively rare entity encountered in everyday’s practice. Risk factors are high-energy accidents, high degree of bony injuries, persistent ligament laxity or varus/valgus deformity, and specific patient factors such as age. The majority of tibia plateau fractures are treated operatively, and the surgical indication is based on fracture morphology.

Complete evaluation should include detailed fracture analysis by means of standard X-rays and a CT scan as well as intra- and extraarticular soft-tissue defects. Other factors that should be considered are preexisting degenerative changes, patient’s activity, comorbidities, and other traumatic causes. Even when all causes have been properly addressed, secondary symptomatic OA can develop. Initial treatment for posttraumatic OA should always be conservative management. When nonsurgical treatment is ineffective, corrective osteotomies, unicondylar knee replacement, total knee replacement or, in exceptional cases, knee arthrodesis can be indicated. Prosthetic joint replacement shows improved knee function, but the results tend to be worse compared to indications for primary osteoarthritis, and the risk of complication is elevated. All options have their own advantages and drawbacks and should be adapted to the patient-specific situation.

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  1. Division of Orthopaedic and Traumatology, Department of Surgery, Geneva University Hospitals, Faculty of Medicine, University of Geneva, Geneva, Switzerland

    Stefanie Hirsiger, Lukas Clerc & Hermes H. Miozzari

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  1. Hip & Knee Reconstruction Surgery Johns Hopkins, Department of Orthopaedic Surgery, Columbia, MD, USA

    Savyasachi C. Thakkar

  2. Department of Orthopaedic Surgery Adult Trauma Service, The Johns Hopkins Medical Institution, Baltimore, MD, USA

    Erik A. Hasenboehler

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Hirsiger, S., Clerc, L., Miozzari, H.H. (2021). Post-traumatic Arthritis of the Proximal Tibia. In: Thakkar, S.C., Hasenboehler, E.A. (eds) Post-Traumatic Arthritis. Springer, Cham. https://doi.org/10.1007/978-3-030-50413-7_11

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