Prospective cohort of 102 patients (106 fractures) treated with ORIF for displaced tibial plateau fractures at a single academic centre. It asks whether patient-reported function, pain, and knee motion change between one year and a minimum of five years postoperatively. Outcomes were measured with the SMFA, VAS/NRS pain scores, and knee ROM.
The practical counseling rule from this paper: tell patients that knee pain and motion stabilize by one year, but overall function can keep improving out to five years.
This matters because prior literature was conflicting, with some cohorts describing functional deterioration and rising TKA rates over decades. This prospective, single-centre modern series sides with the more optimistic outcome data.
The dissociation between radiographs and symptoms is a high-yield teaching point. Nearly half of imaged patients had Kellgren-Lawrence arthrosis, yet most were asymptomatic and only 1% needed arthroplasty at five years. Do not equate radiographic OA with clinical failure.
Weigh the evidence carefully: the study compares patients to themselves at one year rather than to baseline injury, imaging follow-up was incomplete (32 of 102), and the SMFA has no firmly defined MCID, so statistical gains may not equal clinical ones.
Prospective cohort of 102 patients (106 fractures) treated with ORIF for displaced tibial plateau fractures at a single academic centre. It asks whether patient-reported function, pain, and knee motion change between one year and a minimum of five years postoperatively. Outcomes were measured with the SMFA, VAS/NRS pain scores, and knee ROM.
The practical counseling rule from this paper: tell patients that knee pain and motion stabilize by one year, but overall function can keep improving out to five years.
This matters because prior literature was conflicting, with some cohorts describing functional deterioration and rising TKA rates over decades. This prospective, single-centre modern series sides with the more optimistic outcome data.
The dissociation between radiographs and symptoms is a high-yield teaching point. Nearly half of imaged patients had Kellgren-Lawrence arthrosis, yet most were asymptomatic and only 1% needed arthroplasty at five years. Do not equate radiographic OA with clinical failure.
Weigh the evidence carefully: the study compares patients to themselves at one year rather than to baseline injury, imaging follow-up was incomplete (32 of 102), and the SMFA has no firmly defined MCID, so statistical gains may not equal clinical ones.