From the Research
The incidence of developing osteoarthritis after a Schatzker type 2 tibial plateau fracture ranges from 23% to 44% of patients within 5-10 years post-injury. This relatively high rate occurs because Schatzker type 2 fractures involve both depression and splitting of the lateral tibial plateau, creating articular surface incongruity that can lead to abnormal joint mechanics and cartilage wear over time.
Key Factors Influencing Osteoarthritis Development
- Residual articular step-off greater than 2mm after surgical repair
- Advanced patient age
- Higher BMI
- Severity of the initial cartilage damage Early anatomic reduction and stable fixation during surgical treatment can help minimize this risk, though some degree of articular damage is often unavoidable at the time of injury.
Recommended Treatment Approach
The use of anatomically precontoured locking compression plates (LCP) seems to improve radiological and clinical outcomes in Schatzker II fractures, as shown in a study published in 2020 1. Patients should be counseled about this potential long-term complication and advised to maintain a healthy weight, engage in low-impact exercises, and consider joint-protective strategies to potentially delay osteoarthritis progression.
Importance of Early Intervention and Patient Counseling
Given the potential for significant long-term morbidity, early intervention and patient counseling are crucial. This includes discussing the risks of osteoarthritis, the importance of maintaining a healthy lifestyle, and the potential benefits of joint-protective strategies. By prioritizing these aspects, healthcare providers can help mitigate the risk of osteoarthritis and improve patient outcomes.