Khalifa AA, Altahir A, AL-Harbi AM, Althaqafi RMM. Acute total knee arthroplasty for traumatic proximal tibial fractures: A systematic review. World J Orthop 2026; 17(4): 115881 [DOI: 10.5312/wjo.v17.i4.115881]
Corresponding Author of This Article
Ahmed A Khalifa, MD, Assistant Professor, FRCS, Department of Orthopedic, Qena Faculty of Medicine and University Hospital, South Valley University, Kilo 6 Qena-Safaga Highway, Qena 83523, Egypt. ahmed_adel0391@med.svu.edu.eg
Research Domain of This Article
Orthopedics
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
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World J Orthop. Apr 18, 2026; 17(4): 115881 Published online Apr 18, 2026. doi: 10.5312/wjo.v17.i4.115881
Acute total knee arthroplasty for traumatic proximal tibial fractures: A systematic review
Ahmed A Khalifa, Aadla Altahir, Abdullah M AL-Harbi, Raad M M Althaqafi
Ahmed A Khalifa, Department of Orthopedic, Qena Faculty of Medicine and University Hospital, South Valley University, Qena 83523, Egypt
Ahmed A Khalifa, Department of Orthopedic, Aster Sanad Hospital, Riyadh 13216, Saudi Arabia
Aadla Altahir, Department of Orthopedic Surgery, Faculty of Medicine, University of Khartoum, Khartoum 11115, Sudan
Abdullah M AL-Harbi, Department of Orthopedic Surgery, King Abdulaziz University Hospital, Jeddah 22230, Saudi Arabia
Raad M M Althaqafi, Department of Orthopedic Surgery, King Abdulaziz Specialist Hospital, Taif 26311, Saudi Arabia
Raad M M Althaqafi, Department of Orthopedic Surgery, Alhada Armed Forces Hospital, Taif 26311, Saudi Arabia
Author contributions: Khalifa AA contributed to carrying out the study conception and critical revision; Altahir A and Althaqafi RMM contributed to performing data collection and extraction; Altahir A, AL-Harbi AM, and Althaqafi RMM contributed to carrying out data analysis; Khalifa AA and Altahir A contributed equally to the manuscript; and all authors contributed to the literature review, prepared the draft manuscript, designed the tables, discussed and commented on the final manuscript, and read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Ahmed A Khalifa, MD, Assistant Professor, FRCS, Department of Orthopedic, Qena Faculty of Medicine and University Hospital, South Valley University, Kilo 6 Qena-Safaga Highway, Qena 83523, Egypt. ahmed_adel0391@med.svu.edu.eg
Received: October 28, 2025 Revised: November 23, 2025 Accepted: February 4, 2026 Published online: April 18, 2026 Processing time: 164 Days and 18 Hours
Core Tip
Core Tip: Managing proximal tibial fractures, particularly tibial plateau fractures, in elderly patients with osteoporotic bone and pre-existing knee osteoarthritis is challenging. This systematic review evaluated the role of acute total knee arthroplasty as a primary treatment option. Fourteen studies involving 174 patients were analyzed. Most were elderly females with total knee arthroplasty and pre-injury osteoarthritis. Posterior-stabilized implants were commonly used, often with tibial stems and metal augments. Outcomes were favorable, with a mean flexion of 110 degrees and generally good Knee Society Scores. Complications occurred in 16.7%, and revisions in 2.3%. Despite promising results, evidence quality was low, warranting larger comparative studies.
