Journal of Orthopaedic Surgery and Research · IF 2.8 · July 31, 2026 · LoE I
Arthroscopic versus open reduction and internal fixation for tibial plateau fractures: a meta-analysis
Ming Lai, Zelin Huang, Wei Zhao, Lilu Peng, Y. Liu, Penglei Yan — Jiaxing University
This meta-analysis pooled 18 randomized 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.
AI summary · from the full text · reviewed by Pukhraj Gaheer, Medical Student, Queen's University before publishing
Why it mattersTibial 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.
Conclusion strengthPotentially practice-changing
The benefit is 3.98x a 25% relative reduction and the entire 95% CI 2.02 to 4.88 stays above it.
Presenting this at rounds? Start here
- ?For a patient with a simple (Schatzker I-III) tibial plateau fracture, would you now favor an arthroscopic-assisted approach over standard open fixation, and what factors (surgeon experience, equipment access) would influence that choice?
- ?How should this pooled complication and functional-outcome data change counseling for patients about expected recovery and reoperation risk after tibial plateau fracture surgery?