Arthroscopic versus open reduction and internal fixation for tibial plateau fractures: a meta-analysis
Journal of Orthopaedic Surgery and Research · 31 Jul 2026
† Impact is the editorial-priority score. All scores are out of 100. Clinical is a stored clinical-importance score from the earlier method; it has not been recalculated.
Why it matters
Tibial plateau fractures are common trauma cases, and this pooled RCT evidence suggests arthroscopic-assisted fixation for lower-grade fractures may offer better function and fewer complications than the traditional open approach.
The evidence
This meta-analysis pooled 18 randomised controlled trials (1,346 patients) comparing arthroscopy-assisted reduction and percutaneous internal fixation (ARIF) with standard open reduction and internal fixation (ORIF) for Schatzker type I-III tibial plateau fractures. Patients treated with ARIF were about three times more likely to have an excellent-good functional outcome (OR 3.14, 95% CI 2.02-4.88, p<0.001) and had markedly fewer perioperative complications (OR 0.27, 95% CI 0.18-0.40, p<0.001) than those treated with ORIF.
excellent-good functional outcomes: Odds ratio 3.14 (95% CI 2.02 to 4.88; units not reported). The interval favours the first group; the size of the benefit needs clinical interpretation.
Why this rigour score?
Meta-analysis of RCTs
Methods at a glance
Recorded assessment- Comprehensive literature searchNot reported
- Risk of bias assessedNot reported
- Bias considered in synthesisNot reported
- Publication bias assessedNot reported
- Study exclusions justifiedNot reported
- Prospective registrationNot reported
Not reported does not mean not done. Checks have different weights; this is not a count of boxes ticked.
How to read this assessment
The recorded methods are shown alongside the published score. A verified point-by-point calculation is not available for this version of the appraisal.
Checklist from the stored appraisal. “Not met” describes the recorded criterion; it does not always produce a deduction. This overview supports reading the full study.
For journal club
1.For a patient with a simple (Schatzker I-III) tibial plateau fracture, would you now favour an arthroscopic-assisted approach over standard open fixation, and what factors (surgeon experience, equipment access) would influence that choice?
2.How should this pooled complication and functional-outcome data change counselling for patients about expected recovery and reoperation risk after tibial plateau fracture surgery?
Original publication title
Arthroscopic versus open reduction and internal fixation for tibial plateau fractures: a meta-analysis