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Abstract Objective To investigate the clinical outcome of total knee arthroplasty on secondary traumatic arthritis after tibia plateau fracture.Methods From January 2007 to January 2017，13 consecutive patients underwent TKA after tibial plateau fracture，including 9 males and 4 females，with the average age of 57 years，ranging from 43 years to 75 years.The fracture was classified according to Schatzker.There were 1 case of type I，3 cases of type II，4 cases of type III，3 cases of type IV and 2 case of type V.The treatment method were conservative treatment in three cases，and open reduction and internal fixation in ten cases.The mean interval between fracture and knee arthroplasty was 7 years (range：1to 14 years).Patients were assessed pre-operatively and post-operatively using knee society score (KSS) and function score.The flexion and extension ROM of the knee joint was (78.5±32.5) ° pre-operatively.The KSS score was (63.8±12.1)，function score was(62.8±9.8) pre-operatively.Results Implant selection varied according to the pathology found at surgery.Six cases used the posterior stabilized implants.Three cases with tibia bone defect used bone and screws.In three cases，metal wedges and stem were used.Only one case used the constrained implant because of injury of medial collateral ligament.Complications included wound complication in one case，deep venous thrombosis in three cases and stiff knee in one case.Patients were followed up for 68 months on average (range：12 to 113 months).At last follow-up，the KSS score was(81.7±11.1) and function score was (83.5±15.4)，the flexion and extension ROM of the knee joint was (105.4±18.2) °.No case showed significant differences when compared with preoperative values (P＜〓0.05).Conclusion Patients treated with total knee arthroplasty after a previous fracture of the tibial plateau have substantial improvement in function and relief of pain，restoring the alignment of the limbs.However，these patients are at increased risk for peri-operative complications and good surgical skill is required.
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