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

Table 4 Details of the outcomes as reported in each study, mean ± SD

Ref.	Follow up (months)	Weight-bearing status postoperatively	Outcomes
			Functional	ROM	Radiological	Complication	Revision
Abdelbadie et al[28], 2020	27.2 (24-32)	20 FWB (two NWB due to concomitant fractures)	Preoperative vs postoperative KS: 50.5 (42-64) vs 83 (50-100), preoperative vs postoperative KS Function Score: 62 (50-65) vs 84 (60-100)	Preoperative vs postoperative knee flexion: 32.6 degrees (20-40) vs 115 degrees (100-140); preoperative vs postoperative extension lag: 10.4 degrees (5-20) vs 1.4 degrees (0-5)	All were corrected to within a mean of ± 3 degrees neutral mechanical axis	Total of 4 (18.2%); 2 (9.1%) valgus alignment, 1 (4.5%) superficial wound infection, 1 (4.5%) femoral PPF	None
Asikin et al[29], 2022	6	PWB (walking frame training started three days postoperatively)	NR	Painless knee ROM of 0 degree to 90 degrees	Complete bone union with no sign of loosening	None	None
Boureau et al[30], 2015	31 (6-9)	FWB	KSS: 127, KS: 84, KS Function Score: 43, OKS: 35.7, preoperative vs postoperative Parker Score: 7.4 vs 5	NR (the authors reported the ROM for the whole group and did not report the ROM of tibia fracture patients separately)	There were no cases of radiolucency through the follow up period-mean HKA angle was 177 degrees (171 degrees to 180 degrees)	Total of 2: 1 stiffness required MUA, and 1 deep infection managed by irrigation drainage and prolonged antibiotic therapy	None
Haufe et al[31], 2016	27 (12-48)	NR	Mean KS: 81.1 (94-54), mean KS Function Score: 74.5 (100 to -20), and mean WOMAC score: 78.6 (96.2-36.7)	NR	NR	Total of 7: 3 wound healing deficit, 1 intraoperative PPF, 1 PJI, 1 retained intraarticular cement, 1 loosening	NR
Hesmerg et al[32], 2024	34.8 (16.8-170.4)	NR	KOOS-PS score 73 (59-93); OKS 43 (30-47), EQ-5D-5 L index 0.87 (0.69-1); EQ-5D VAS 80 (71-94)	NR	NR	One patient had stiffness requiring MUA	NR
Huang et al[33], 2016	32.3 (25-41)	5 FWB and 1 PWB	HSS score: 89.8 (85-94)	Knee flexion: 119.2 degrees (105 degrees to 130 degrees)	NR	None	None
Kadakia et al[34], 2007	6	NR	NR	Painless knee ROM 0 degree to 100 degrees	No loosening	PJI	None
Mirzatolooei et al[35], 2021	24	PWB	Preoperative vs postoperative Tegner Activity Scale: 2.2 ± 1.4 vs 4.3 ± 1.4, KS: 88.7 ± 5.4, KS Function Score: 59.4 ± 8.2, preoperative vs postoperative median HSS scale: 42 (16-58) vs 78 (72-91); preoperative vs postoperative pain severity: 65.2 ± 12.3 vs 35.5 ± 11.3	Preoperative vs postoperative median ROM: 85 degrees (55 degrees to 98 degrees) vs 97 degrees (95 degrees to 110 degrees)	NR	2 DVT	None
Sabatini et al[36], 2023	28 ± 14 (12-48)	NR	KS: 83 ± 16 (48 to 97), KS Function Score: 74 ± 15 (32 to 88); preoperative vs postoperative Parker’s Scale was 7.5 ± 1.4 (5-9) vs 5.6 ± 1.3 (3-8) (P < 0.05); FJS: 66 ± 14, (42 to 94)	Knee flexion was 116 degrees ± 7 degrees (110 degrees to 130 degrees), 10 patients had full knee extension, one patient had an extension lag of 10 degrees	No radiolucency, all had neutral alignment (HKA between ± 3 degrees); based on patellar indices, there were no cases of patella alta; only one patient had a CDI and BPI consistent with a patella baja (CDI = 0.54 and BPI = 0.56)	1 PJI, 1 extension lag of 10 degrees, 1 femoral PPF, 1 DVT	One required DAIR to treat PJI
Sarzaeem et al[37], 2017	54 ± 13 (36-72)	PWB	KS: 90.7 ± 6.5 (67-97), KS Function Score: 69.6 ± 8.8 (41-85); preoperative vs postoperative Tegner Activity Scale: 2.5 ± 1.2 (1-5) vs 3.5 ± 1.3 (2-6); the mean VAS for satisfaction: 8.1 ± 1 (6-10) and VAS Pain Score: 1.5 ± 1.2	Knee flexion range was significantly higher than the contralateral uninjured side: 106 degrees ± 13 degrees vs 120 degrees ± 8 degrees	No case of septic or aseptic loosening	None	None
Sivasubramanian et al[38], 2016	56 (18-82)	FWB	KSS: 88, no pain	Knee flexion: 122 degrees (105 degrees to 132 degrees); no fixed flexion deformity or hyperextension	Radiological fracture union at a mean of 3 months (2 months to 5 months); alignment of within 3 degrees of the mechanical axis was achieved in 2 patients (2.8 varus and 3.0 valgus)	1 valgus alignment of 7.2 degrees	None
Tapper et al[39], 2020	19 ± 16	FWB	KSS score: 160 ± 39; OKS 27 ± 11	Knee flexion: 109 degrees ± 16 degrees; extension deficit in three patients	NR	1 stiffness, 1 PJI	2
Vermeire and Scheerlinck[40], 2010	31 (1.3-81)	7 FWB, 3 PWB, 2 NWB (due to due to concomitant fractures)	Median KS: 78 (50-100), median KS Function Score: 58 (0-100); five patients had no pain at all	Knee flexion: 115.9 degrees (95 degrees to 130 degrees); no patients had hyperextension	Nine patients had a normal knee mechanical alignment (± 3 degrees HKA) and two showed a discrete valgus alignment compared to the contralateral side. No signs of loosening	3 developed a hematoma, 1 DVT, 1 PJI	None
Wui et al[41], 2020	22.3 ± 13.9	FWB	KS: 97 and 88; KS Function Score: 80 and 90	One patient (0 degree to 90 degrees) the other (0 degree to 130 degrees)	NR	None	None

ROM: Range of motion; FWB: Full weight bearing; NWB: Non-weight bearing; KS: Knee Score; PPF: Periprosthetic fracture; PWB: Partial weight bearing; NR: Not reported; MUA: Manipulation under anesthesia; OKS: Oxford Knee Score; WOMAC: Western Ontario and McMaster Universities Osteoarthritis Index; KOOS: Knee Injury and Osteoarthritis Outcome Score; VAS: Visual Analogue Scale; HSS: Hospital of special surgery; HKA: Hip to knee to ankle; PJI: Periprosthetic joint infection; DVT: Deep venous thrombosis; DAIR: Debridement, antibiotic irrigation, and implant retention; CDI: Caton-Deschamps index; BPI: Blackburn-Peel index; KSS: Knee Society Score.