Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2025 May 27;26(1):522.
doi: 10.1186/s12891-025-08786-7.

Prevalence of osteoarthritis and clinical outcomes in patients with fractures of the tibial plateau - medium- and long-term analysis

Jon Klasér #  1 , Lisa Kotake #  1 , Marcus Lindberg #  1 , Simon Wigge #  1 , Robert Lundqvist  2 , Grzegorz Szczęsny  3 , Przemysław T Paradowski  4   5
Affiliations
Observational Study

Prevalence of osteoarthritis and clinical outcomes in patients with fractures of the tibial plateau - medium- and long-term analysis

Jon Klasér et al. BMC Musculoskelet Disord. .

Abstract

Background: The incidence of post-traumatic osteoarthritis (OA) following intraarticular knee fractures has been estimated to be relatively high but it varies substantially between different reports. In this study we sought to assess the prevalence of radiographic knee OA secondary to tibial plateau fractures (TPF). The second aim was to report medium- and long-term functional outcomes and investigate whether there were any risk factors associated with these outcomes.

Methods: We retrospectively reviewed documentation of patients who had TPF between 2001 and 2015. The radiographs, clinical characteristics and patient-reported outcome measures (PROMs) scores were evaluated. Presence of radiographic OA was the primary endpoint. The other endpoints were the relationship between OA and different potential predictors as well as the scores in PROMs.

Results: The study involved a total of 130 patients including 114 who were radiographically examined at mean follow-up time of 10 years (range 4.6-19.3 years). Radiographic OA was present in 50% of patients (34% in the injured knee and 16% in both knees). Having OA in the contralateral knee increased the odds to develop OA in the index knee (OR = 4.8; 95%CI 1.6-4.1 in the crude model and OR = 6.6; 95%CI 1.8-23.5 in the model adjusted for age, sex, BMI, fracture type and treatment method). The occurrence of OA was associated stronger with medial or bicondylar TPF than with lateral condyle TPF (OR = 2.8; 95%CI 1.2-6.1 in the crude model and OR = 3.4; 95%CI 1.4-8.6 in the adjusted model). The KOOS scores were significantly lower in patients with OA than in those without OA in the index knee in all the KOOS subscales (p < 0.007), except for the KOOS Symptoms (p = 0.362). The EQ-5D-5L index score was significantly higher in patients without OA in the index knee compared to those with OA (p = 0.015).

Conclusion: Radiographic OA following TPF occurred in 50% of knee joints. The odds for knee OA were highest after medial or bicondylar fractures. Patients with OA in the index knee had lower scores in both condition-specific and generic PROMs than subjects without OA, which indicates that TPF may contribute to the development of both OA disease and illness.

Trial registration: The trial was registered retrospectively on June 4, 2024 on ClinicalTrials.gov (registration number: NCT06451510).

Keywords: Knee; Osteoarthritis; Outcome; Tibial plateau fracture.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was conducted in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved the Research Ethics Committee of Umeå University and acquired ethical approval (DNR: 2016/20-31) with regards to access to patient medical records, clinical examinations and radiographic procedures of included patients as well as their later assessment. In addition, the patient exposure to radiation was tested and approved by the Radiation Protection Committee for Region Norrbotten (approval dated October 13, 2020). Consent to participate: The patients were informed in writing and orally by the study personnel, and a written informed consent was obtained from all subjects. Participation was voluntary, and withdrawal was possible at any time. All patients signed and personally dated the informed consent forms at admission to hospital, before participating in the study. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart presenting the study group formation
Fig. 2
Fig. 2
Comparison of the KOOS scores in patients following tibia plateau fracture. Each diagram shows the index values in patients with (orange boxplots) and without osteoarthritis (OA) (gray boxplots) in the index knee, contralateral knee and in both knees, in all five KOOS subscales. The whiskers represent minimum and maximum values while the horizontal line inside the box is the median value. The 25 th and the 75 th percentiles mark the upper and lower end of the box. P value is given over the boxes
Fig. 3
Fig. 3
Comparison of the EQ-5D-5L index in patients following tibia plateau fracture. Each diagram shows the index values in patients with (orange boxplots) and without osteoarthritis (OA) (gray boxplots) in the index knee, contralateral knee and in both knees. The whiskers represent minimum and maximum values while the horizontal line inside the box is the median value. The 25 th and the 75 th percentiles mark the upper and lower end of the box. P value is given over the boxes
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Verbrugge LM, Patrick DL. Seven chronic conditions: their impact on US adults’ activity levels and use of medical services. Am J Public Health. 1995;85(2):173–82. - PMC - PubMed
    1. Lawrence RC, Felson DT, Helmick CG, Arnold LM, Choi H, Deyo RA, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. Arthritis Rheum. 2008;58(1):26–35. - PMC - PubMed
    1. Felson DT, Naimark A, Anderson J, Kazis L, Castelli W, Meenan RF. The prevalence of knee osteoarthritis in the elderly. The Framingham Osteoarthritis Study. Arthritis Rheum. 1987;30(8):914–8. - PubMed
    1. Andrianakos AA, Kontelis LK, Karamitsos DG, Aslanidis SI, Georgountzos AI, Kaziolas GO, et al. Prevalence of symptomatic knee, hand, and hip osteoarthritis in Greece. The ESORDIG study J Rheumatol. 2006;33(12):2507–13. - PubMed
    1. Peat G, McCarney R, Croft P. Knee pain and osteoarthritis in older adults: a review of community burden and current use of primary health care. Ann Rheum Dis. 2001;60(2):91–7. - PMC - PubMed

Publication types

MeSH terms

Associated data