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Peer-reviewedCC BY-NC-ND 4.0Journal of Orthopaedic Surgery and Research

Arthroscopic versus open reduction and internal fixation for tibial plateau fractures: a meta-analysis

  • Ming Lai1
  • Zelin Huang2
  • Wei Zhao1
  • Lilu Peng1
  • Yunhai Liu1
  • Penglei Yan3
  1. 1Department of Joint Surgery/Osteoporosis, The Third Affiliated Hospital of Jiaxing University ( Zhejiang Rongjun Hospital ), Jiaxing City, 314031 Zhejiang Province China
  2. 2Department of Pediatric Orthopedics /Hand and Foot Surgery, The Second Affiliated Hospital of University of South China, Hengyang City, 421099 Hunan Province China
  3. 3Department of Spinal Surgery/Sports Medicine Center, The Third Affiliated Hospital of Jiaxing University ( Zhejiang Rongjun Hospital ), No. 309 Shuangyuan Road, Nanhu District, Jiaxing City, 314031 Zhejiang Province China
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Abstract

Objective: To systematically compare the efficacy and safety of arthroscopy-assisted reduction and percutaneous internal fixation (ARIF) versus open reduction and internal fixation (ORIF) for Schatzker type I-III tibial plateau fractures.

Methods: A comprehensive literature search was conducted across PubMed, Embase, Cochrane Library, Web of Science, and CNKI up to November 2025. Randomized controlled trials (RCTs) comparing ARIF with ORIF were included. Data on functional outcomes and complication rates were extracted and pooled using random-effects models. The Cochrane Risk of Bias tool and GRADE approach were used for quality assessment.

Results: Eighteen RCTs involving 1, 346 patients were included. Pooled analysis demonstrated that ARIF was associated with significantly superior excellent-good functional outcomes (OR = 3.14, 95%CI: 2.02–4.88, p < 0.001) and substantially reduced perioperative complication rates (OR = 0.27, 95%CI: 0.18–0.40, p < 0.001) compared to ORIF.

Conclusion: For Schatzker type I-III tibial plateau fractures, ARIF provides superior functional recovery and significantly lower complication rates compared to ORIF. As a result, ARIF represents a favorable treatment option for these fracture patterns.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s13018-026-07121-7.

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Cite

BibTeXRIS
BibTeX
@article{lai2026arthroscopic,
  title = {{Arthroscopic versus open reduction and internal fixation for tibial plateau fractures: a meta-analysis}},
  author = {Ming Lai and Zelin Huang and Wei Zhao and Lilu Peng and Yunhai Liu and Penglei Yan},
  journal = {Journal of Orthopaedic Surgery and Research},
  year = {2026},
  month = jul,
  doi = {10.1186/s13018-026-07121-7},
  url = {https://doi.org/10.1186/s13018-026-07121-7},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Arthroscopic versus open reduction and internal fixation for tibial plateau fractures: a meta-analysis
AU  - Ming Lai
AU  - Zelin Huang
AU  - Wei Zhao
AU  - Lilu Peng
AU  - Yunhai Liu
AU  - Penglei Yan
PY  - 2026
DA  - 2026/07/31
JO  - Journal of Orthopaedic Surgery and Research
DO  - 10.1186/s13018-026-07121-7
UR  - https://doi.org/10.1186/s13018-026-07121-7
AB  - Objective: To systematically compare the efficacy and safety of arthroscopy-assisted reduction and percutaneous internal fixation (ARIF) versus open reduction and internal fixation (ORIF) for Schatzker type I-III tibial plateau fractures.  Methods: A comprehensive literature search was conducted across PubMed, Embase, Cochrane Library, Web of Science, and CNKI up to November 2025. Randomized controlled trials (RCTs) comparing ARIF with ORIF were included. Data on functional outcomes and complication rates were extracted and pooled using random-effects models. The Cochrane Risk of Bias tool and GRADE approach were used for quality assessment.  Results: Eighteen RCTs involving 1, 346 patients were included. Pooled analysis demonstrated that ARIF was associated with significantly superior excellent-good functional outcomes (OR = 3.14, 95%CI: 2.02–4.88, p < 0.001) and substantially reduced perioperative complication rates (OR = 0.27, 95%CI: 0.18–0.40, p < 0.001) compared to ORIF.  Conclusion: For Schatzker type I-III tibial plateau fractures, ARIF provides superior functional recovery and significantly lower complication rates compared to ORIF. As a result, ARIF represents a favorable treatment option for these fracture patterns.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s13018-026-07121-7.
SN  - 1749-799X
ER  -