Acute total knee arthroplasty for traumatic proximal tibial fractures: A systematic review

Table 1 Basic studies, patients’, and fracture characteristics, mean ± SD/n (%)

Ref.	Country	Study type	Total number of patients included in the study	Number of patients who had aTKA	Age	Gender		Comorbidities	Concomitant knee OA	Evaluating abnormal bone profile (author’s remarks)	Fracture details
						Male	Female				Trauma mechanism	Fracture location	Classification
Abdelbadie et al[28], 2020	Egypt	Retrospective cohort study	43 (22 aTKA vs 21 ORIF)	22	67.1 (60-73)	8	14	86.4% of the patients [diabetes (36.4%), HT (35.5%), IHD (27.3%), CLD (4.5%)]	5 (22.7)	NA [9 (40.9) patients were on bisphosphonates]	14 high energy (6 falls, 2 RTA, 6 MCA)	TPFs	Schatzker type II (7, 31.8%), Schatzker type III (8, 36.4%), Schatzker type IV (7, 31.8%)
Asikin et al[29], 2022	Malaysia	Case report	1	1	75	1	0	NR	NR	NA	High energy (MCA)	TPFs	Schatzker type V
Boureau et al[30], 2015	France	Case series	21 (10 distal femur fractures and 11 proximal tibia fractures)	11	79 (68-96)	8	3	NR (ASA III: 6, ASA II: 5)	NR	NA (all patients showed radiologic osteopenia)	NR	TPFs	5 Schatzker II, 2 Schatzker IV, 3 Schatzker V and 1 Schatzker VI
Haufe et al[31], 2016	Germany	Case series	30	30	78.4 (59-93)	13	17	NR	NR	NA	NR	TPFs	AO/OTA: Type B (13), type C fracture (17); 6: 41B2, 5: 41B3, 5: 41C1, 7: 41C2, and 7: 41C3
Hesmerg et al[32], 2024	Netherlands	Retrospective cohort study	68 (34 matched pairs: 12 aTKA vs 22 late TKA)	12	69.0 (65.3-79.5) (median)	1	11	NR [ASA I/II: 8 (66.7%)]	NR	NA	Traffic accident 2 (16.7%), fall from height 4 (33.3%), blunt trauma 1 (8.3%); other 4 (33.3%), unknown 1 (8.3%)	TPFs	Schatzker II (2, 16.7%). Type III (3, 25.0%). Type IV (1, 8.3%). Type V (4, 33.3%). Type VI (2, 16.7%)
Huang et al[33], 2016	China	Case series	6	6	69.5 (58-78)	3	3	NR	NR	NA	All were high energy (traffic accidents and falls from height)	TPFs	4 Schatzker V and 2 Schatzker VI
Kadakia et al[34], 2007	United Kingdom	Case report	1	1	85	0	1	NR: Patient’s chest radiograph showed evidence of previous scarring	NR	NA (operative findings revealed that the bone was mushy and porotic)	Low energy (fell on the knee from standing height)	TPFs	Schatzker type IV
Mirzatolooei et al[35], 2021	Iran	Case series	11	11	54.3 ± 4.7	0	11	RA [all patients were on anti-RA agents, especially corticosteroid (prednisolone) for at least 5 years (range: 5-8)]	11 (100)	It was evaluated by DXA scan 6 months before the surgery; the mean T-score was -3.8 ± 0.7	All were low energy	PTFs	NR
Sabatini et al[36], 2023	Italy	Case series	11	11	76 ± 6 (65-84)	4	7	NR	11 (100)	NA	8 low energy (simple fall), 3 high energy (car accident)	TPFs	AO/OTA: Type B (8), type C fracture (3); one (41B1), 5 (41B3), 2 (41B2), 1 (41C1), 2 (41C2)
Sarzaeem et al[37], 2017	Iran	Case series	30	30	67.6 ± 4.2 (61-78)	19	11	NR	23 (76.7)	NA (7 had osteoporosis)	14 high energy	TPFs + PTFs	AO/OTA: Type A (5), type B (22), type C fracture (3); 5 (41A), 22 (41 B), 3 (41 C)
Sivasubramanian et al[38], 2016	Singapore	Case series	3	3	70.4 (59.2-79.0)	1	2	NR	3 (100)	NA (poor bone stock)	All high energy	TPFs	2 Schatzker II and one Schatzker III
Tapper et al[39], 2020	Finland	Case series	22	22	74 ± 12 (53-88)	6	16	NR	5 (22.7)	NA (deficient bone stock)	13 low energy, 9 high energy	TPFs	6 Schatzker II, 7 Schatzker III, 2 Schatzker IV, 5 Schatzker V, 2 Schatzker VI
Vermeire and Scheerlinck[40], 2010	Belgium	Case series	12	12	73 (58-81)	3	9	NR	5 (41.7)	NA	6 low energy, 6 high energy	TPFs	AO/OTA: Type B (9), type C fracture (3); one 41-B1, 8: 41-B3, 3: 41-C3
Wui et al[41], 2020	Malaysia	Cross-sectional study	10 (6 distal femur, 2 proximal tibial, and 2 combined distal femur and proximal tibial fractures)	2	64 (55-76)	1	1	NR	NR	NA (poor bone quality)	NR	TPFs	AO/OTA: Type C fracture (2); one 41C3.1, one 41C3.3

TKA: Total knee arthroplasty; OA: Osteoarthritis; ORIF: Open reduction and internal fixation; NR: Not reported; NA: Not available; HT: Hypertension; IHD: Ischemic heart disease; CLD: Chronic liver disease; PTFs: Proximal tibial fractures; TPFs: Tibial plateau fractures; AO/OTA: Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association.