Long-term patient-reported knee-related outcomes and quality of life of patients with tibial plateau fractures; a mixed methods study

Purposes: This study aims to 1) provide a comprehensive assessment of the long-term functional outcomes in patients who sustained a tibial plateau fracture by combining patient-reported outcomes and a qualitative analysis of their healthcare experiences and 2) compare the long-term outcomes of tibial plateau fracture patients with a matched healthy population. Methods: All eligible patients (n=165) were treated for a tibial plateau fracture at a level-1 trauma center in Australia and were asked to complete the KOOS and EQ-5D-5L questionnaire. Additionally, the outcomes (KOOS and EQ-5D-5L) of our patient sample were compared to those of a matched sample of the general population. Lastly, in-depth interviews were conducted in a subset of participating patients to gain insight in their treatment experiences. Results: Out of 165 patients, 46 patients (28% response rate) agreed to participate in this study and 18 patients consented to an additional interview. Patient demographics showed a mean age of 52.8 years, ranging from 18 to 72 years. Patients who sustained a tibial plateau fracture exhibited significant deterioration compared to a matched healthy population, with decreases ranging from 17 to 38 points in each KOOS questionnaire subcategory respectively. Moreover, their quality of life, as measured by the EQ-5D-5L index score, significantly declined for patients with tibial plateau fractures (0.79±0.26) compared to a matched health population (0.88±0.03). The qualitative analysis highlights patient perspectives and suggests potential improvements, such as standard referral to physical therapy and optimization of support services, to enhance both short-term and long-term outcomes for patients who suffered from a tibial plateau fracture. Conclusion: This study demonstrates the substantial impact of tibial plateau fractures on knee-related outcomes and quality of life for patients, even 5-10 years post-injury, when compared to a matched healthy population. The qualitative findings of this study emphasize the importance of implementing physical therapy and improving support services to potentially achieve better outcomes for patients with tibial plateau fractures. Trial registration: This study was approved by the hospitals’ local ethics committee (Southern Adelaide Local Health Network LNR/22/SAC/174).