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. 2020 Jun;33(6):611-615.
doi: 10.1055/s-0039-1683893. Epub 2019 Mar 27.

Age-Related Variances in Patients with Tibial Plateau Fractures

Lasun O Oladeji  1 , John R Worley  1 , Brett D Crist  1
Affiliations

Age-Related Variances in Patients with Tibial Plateau Fractures

Lasun O Oladeji et al. J Knee Surg. 2020 Jun.

Abstract

Tibial plateau fractures account for approximately 8% of fractures in the elderly population. Treatment strategies in the elderly are similar to those for younger patients; however, practitioners must account for the elevated comorbidity burden in this population. To date, few studies have analyzed age-based outcomes in patients with tibial plateau fractures. Therefore, the purpose of this study was to determine age-related variances in demographics, fracture characteristics, mechanism of injury, and complications. A 10-year retrospective review was conducted to identify patients who received treatment for a tibial plateau fracture. There were 351 patients (360 tibial plateau fractures) who were identified and subsequently stratified according to their age at the time of injury. Patients were classified as elderly if they were 65 years of age or older at the time of injury; all other patients were included in the control cohort. These two cohorts were analyzed using bivariate analysis to isolate for age-related variations with respect to risk factors, mechanism of injury, and complications. There were 351 patients (360 tibial plateau fractures) with a median follow-up of 1.84 ± 2.44 years who met inclusion criteria. There were a greater proportion of women in the elderly cohort as compared with the younger cohort (60.0 vs. 43.4%, p = 0.06). Elderly patients were significantly more likely to present with diabetes (33.3 vs. 16.1%, p = 0.01) or osteoporosis (14.3 vs. 1.6%, p = 0.001). Younger patients were significantly more likely to require further surgery to address ligament (12.6 vs. 0%, p = 0.008), meniscus (20.9 vs. 7.1%, p = 0.036), or cartilage pathology (13.6 vs. 0%, p = 0.005). There was no difference in the arthroplasty conversion rate (4.8% elderly vs. 7.9% control, p = 0.755). While elderly patients presented with a greater comorbidity burden, they had equivalent or better short-term outcomes when compared with their younger peers when treated with open reduction and internal fixation (ORIF). Despite the recent interest in primary total knee arthroplasty for elderly patients with tibial plateau fractures, the results of this study suggest that elderly patients may respond well when treated with ORIF following a tibial plateau fracture.

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Conflict of interest statement

B. D. C. reports other from AO Trauma North America, personal fees from Globus Medical, other from International Geriatric Fracture Society, other from the Journal Of Hip Preservation, other from the Journal Of Orthopaedic Trauma, grants and personal fees from Acelity KCI, other from Orthopaedic Implant Company, other from Orthopaedic Trauma Association, personal fees from Pacira, other from SLACKIncorporated, other from SMV, grants From Depuy Synthes, outside the submitted work. All other authors have nothing to disclose.