How Is a Tibial Plateau Fracture Treated?
If you have a non-displaced tibial plateau fracture, our knee specialist, Dr. Michael K. Shindle, may recommend a knee brace, NSAIDs, and PRP to restore joint function. However, if the joint is displaced or unstable, you may need open reduction and internal fixation (ORIF), external fixation, or bone grafting to rebuild the damaged joint surface and improve knee function.
After the treatment, our surgeon, Dr. Michael K. Shindle at Total Orthopedics and Sports Medicine, will provide a structured recovery plan to help you regain strength and mobility. This plan may include gradual weight-bearing, guided exercises, and regular follow-ups to monitor healing and prevent complications. Call us at 855-321-6784 to book an appointment with Dr. Michael K. Shindle in Clifton.
What Are The Treatment Options for a Tibial Plateau Fracture?
Nonsurgical treatment, including activity modification, pain medications, regenerative treatments, and joint injections, can help manage mild or non-displaced fractures. These treatments reduce pain, support healing, and protect the joint while it recovers. In severe cases, surgical treatments such as external fixation, knee replacement (arthroplasty), and bone grafting can help realign the bone and stabilize the joint. Here is how these treatments help restore joint function and protect overall knee health:
Activity Modification
To support proper healing and prevent further injury, it is important to modify your daily activities if you have a tibial plateau fracture. You should avoid the following high-impact movements that can strain the fracture site:
- Running or jogging on hard surfaces
- Jumping or landing from a height
- Pivoting or sudden twisting movements
- Deep squatting or full knee bending
- Climbing stairs repeatedly during early healing
- Lifting heavy weights while standing or bending
- High-resistance gym exercises involving the lower body
- Contact sports like football, basketball, or rugby
Pain Medications and Joint Injections
Pain medications and joint injections help control discomfort and inflammation in your knee. For instance, NSAIDs reduce pain, swelling, and stiffness by reducing joint inflammation. Similarly, corticosteroid injections can reduce joint inflammation by delivering medication directly into the knee, helping relieve pain and improve short-term mobility.
Moreover, if a tibial plateau fracture is left untreated or heals improperly, it can even lead to knee osteoarthritis. In such cases, corticosteroid injections can help relieve pain and improve short-term joint movement. In fact, a PubMed study reported that intra-articular corticosteroid injections can improve symptoms of knee osteoarthritis, especially in the short term. This study revealed the following clinical outcomes:
Regenerative Treatments
Regenerative treatments such as viscosupplementation and stem cell technology are used to control knee joint degeneration, reduce pain, and improve knee function. Here’s how these treatments support natural healing and improve joint health:
- Viscosupplementation: Improves joint lubrication using hyaluronic acid injections, helping reduce friction and stiffness during movement.
- Stem Cell Technology: Delivers regenerative cells that may help support tissue healing, reduce inflammation, and improve the joint environment in select cases.
External Plate Fixation
External fixation is a surgical treatment used to manage severe or unstable tibial plateau fractures. In this procedure, the surgeon inserts metal pins into the bone above and below the fracture site. Then these pins are connected to an external frame placed outside the leg, which keeps the bone properly aligned while it heals.
This technique helps maintain knee joint stability without directly disturbing the injured soft tissues. In addition, it is commonly used in high-energy injuries with significant swelling or soft tissue damage, such as:
- Car accident–related tibial plateau fractures
- Sports-related high-impact trauma injuries
- Fall from height, causing complex knee fractures
- Crush injuries involving severe joint swelling
- Multi-fragment (comminuted) fractures of the knee joint
- Open fractures with soft tissue injury or contamination
Knee Arthroplasty
In a knee replacement, the knee surgeon may remove the damaged parts of your knee joint and replace them with artificial components, including:
- Metal components to replace the damaged bone surfaces
- Plastic spacers to allow smooth joint movement
- Prosthetic implants that restore joint alignment
- Artificial cartilage surfaces to reduce friction
- Stabilizing components to improve joint support
Additionally, a PMC study evaluated the management of displaced proximal tibia fractures in elderly patients using knee arthroplasty. This study included 11 patients treated between 2015 and 2019, with an average follow-up of 28 months. The results showed a mean Knee Society Score (KSS) of 83 ± 16 (83% functional knee performance). Similarly, the functional outcome score was 74 ± 15 (74% overall functional ability after treatment).
Bone Grafting
Bone grafting is a surgical procedure used in severe tibial plateau fractures if there is bone loss or structural damage. In this procedure, the surgeon places healthy bone material into the damaged area to rebuild and support the knee joint structure. After the procedure, you may experience improved joint support and better overall knee function. Here are different types of bone grafts used in this orthopedic surgery:
- Autograft (your own bone)
- Allograft (donor bone)
- Synthetic graft (man-made material)
- Cancellous graft (spongy bone)
Which Types of Tibial Plateau Fractures are Common?
The most common types of tibial plateau fractures include medial plateau fractures, bicondylar fractures, and lateral split-depression fracture patterns. Comminuted fractures and central depression fractures are also common in cases involving high-impact trauma or direct force to the knee joint. Here’s how tibial plateau fractures affect your knee joint function and how they occur:
Medial Plateau Fracture
A medial plateau fracture affects the inner side of the tibial plateau. It usually occurs due to high-energy trauma or direct force to the inner knee. Since this area carries a significant amount of body weight, injury can directly affect knee stability and normal joint mechanics. The fracture can also disrupt proper load distribution across the articular surface, leading to uneven pressure during movement. As a result, you may experience pain, difficulty bearing weight, and joint instability.
Bicondylar Tibial Plateau Fractures
A bicondylar fracture involves both the medial and lateral plateaus. It usually occurs due to severe high-energy trauma, such as motor vehicle accidents or major falls. Moreover, this fracture significantly destabilizes the knee joint by disrupting overall alignment. It can also reduce your ability to bear weight and perform normal movements such as:
- Walking or standing for long periods
- Bending and straightening your knee
- Climbing stairs
- Squatting or kneeling
- Maintaining balance during movement
Lateral Split-Depression Fracture
A lateral split-depression fracture affects the outer part of your knee joint. This type of fracture usually occurs when a strong force pushes the bone inward while also splitting it, leading to both structural breakage and depression of the joint surface. This injury can disrupt the smooth alignment of the knee joint, affecting normal movement and load distribution. Because of this, you may experience severe pain, inflammation, and difficulty bending or bearing weight on the affected leg. The uneven joint surface can also lead to restricted motion and instability.
Comminuted Fracture
In a comminuted fracture, the knee bone breaks into multiple fragments due to high-impact trauma, affecting the tibial plateau. This type of injury often results from severe accidents or falls and leads to significant disruption of the joint surface. Since the bone is broken into several pieces, normal knee alignment and stability are affected. In severe cases, it can also lead to a broken kneecap if the impact force extends to the patella, worsening pain, swelling, and joint instability.
Central Depression Fracture
A central depression fracture occurs when the middle part of the tibial plateau collapses. This injury usually results from a direct axial force, such as landing on the knee during a fall or accident. In such cases, the downward force pushes the bone surface inward, creating an uneven joint surface. This disruption affects normal knee alignment and makes smooth joint movement difficult.
If you are experiencing symptoms of a tibial plateau injury, such as pain, swelling, or knee instability, early evaluation is important to prevent long-term joint damage. At Total Orthopedics and Sports Medicine, Dr. Michael K. Shindle carefully evaluates all types of knee fractures to design a targeted treatment plan. This treatment plan may include bracing, injections, or surgical intervention to restore knee joint function. Call us at 855-321-6784 to book an appointment today.
How Is a Tibial Plateau Fracture Diagnosed?
To diagnose a tibial plateau fracture, our knee surgeon, Dr. Michael K. Shindle, may conduct a detailed physical exam of your knee joint and tibia. During this exam, he performs clinical tests, such as varus and valgus stress tests, to evaluate ligament stability around the knee and check for joint laxity. He also assesses swelling, tenderness, and your ability to move the knee in different directions, such as:
- Bending (flexion): Limited movement or discomfort may indicate joint surface involvement or compression of the tibial plateau.
- Straightening (extension): Discomfort during this may signal swelling within the joint or fracture displacement.
- Rotation (inward or outward): Restricted motion may point to associated soft tissue injury along with the tibial plateau fracture.
- Weight-bearing (standing or walking): Pain or inability to bear weight may indicate an unstable fracture or loss of joint support.
In addition, Dr. Michael K. Shindle may order an X-ray (radiograph) or an MRI scan to confirm the diagnosis. X-rays can help identify fractures, assess bone alignment, and detect displacement or depression of the tibial plateau. Similarly, MRI provides more detailed images of ligaments and surrounding structures, including cartilage, for a complete evaluation. In fact, research co-authored by Dr. Michael K. Shindle found that magnetic resonance imaging (MRI) of the knee is highly effective for assessing knee articular cartilage.
Can Casting Fix a Broken Tibia?
Yes, casting can fix a broken tibia if the fracture is stable and non-displaced. In such cases, Dr. Michael K. Shindle may recommend a cast to keep the bone properly aligned, limit movement, and allow natural bone healing over time. This treatment is most effective when the bone fragments remain in their original positions, and the knee joint is stable.
However, if the fracture is displaced, unstable, or involves multiple bone fragments, casting alone is usually not enough. In such cases, Dr. Michael K. Shindle may recommend additional treatment, such as surgical fixation, to properly realign the bone and restore normal knee range of motion.
How Does ORIF Surgery Repair a Tibial Plateau Fracture?
ORIF (Open Reduction and Internal Fixation) realigns the fractured tibial plateau and stabilizes the bone using plates and screws to restore the knee joint’s shape and function. During this procedure, the surgeons make an incision over the knee to directly access the fractured tibial plateau. After that, they carefully realign the bone fragments into their original position (open reduction) to restore joint surface alignment.
Once the joint surface is restored, the surgeon may secure the bone fragments using metal plates and screws. These implants hold the bone in place and maintain alignment while the fracture heals. In cases where the joint surface has collapsed, the surgeon may also elevate the bone and use bone graft material to fill the gap and support the structure.
This procedure helps restore knee stability, improve load distribution across the joint, and support long-term functional recovery. It also helps prevent stiffness and reduces the risk of post-traumatic arthritis (PTOA). After surgery, our knee specialists, Dr. Michael K. Shindle, provide a structured recovery plan to support proper healing, restore knee muscle strength, and gradually improve mobility. For your convenience, we also offer online tools that provide easy bill payment, medical record access, and clear surgical instructions. Call us at 855-321-6784 to schedule your consultation.
When Is Arthroscopy Required for Fracture Treatment?
You may need arthroscopy as part of tibial plateau fracture treatment if the injury involves joint surface damage, loose bone fragments, or associated cartilage and ligament injuries. Our knee surgeon, Dr. Michael K. Shindle, may also recommend arthroscopy when imaging reveals soft-tissue damage that requires detailed evaluation.
In this procedure, the surgeon inserts a small camera (arthroscope) into the knee joint through small incisions. This arthroscope helps them visualize the damaged area of the tibial plateau. After that, the surgeon carefully examines the joint surface and removes loose bone or cartilage fragments to restore joint movement. They may also use the following advanced technologies during the procedure to improve arthroscopy outcomes:
- Fluid irrigation system: Continuously clears blood and debris for better visualization
- Motorized shaver tools: Precisely remove damaged cartilage and smooth irregular joint surfaces
- Arthroscopic graspers: Help securely remove loose bone or cartilage fragments from the joint
- Mini-fragment fixation tools: Assist in stabilizing small bone pieces during minimally invasive repair
Which Braces Are Used After a Knee Injury?
After a knee injury, you may need a hinged knee brace, a rehabilitative brace, and functional braces. An unloader brace, a knee immobilizer, a patellofemoral brace, and a compression brace can also help limit abnormal movement after a knee fracture. Here is how these braces help improve knee function and reduce pain or swelling:
- Hinged brace: Controls side-to-side movement and supports safe bending and straightening of the knee.
- Rehabilitative brace: Restricts knee motion in early healing to protect the fracture and prevent re-injury.
- Functional brace: Provides support during walking and daily activities while allowing controlled movement.
- Unloader brace: Reduces pressure on the injured knee to improve alignment and decrease pain.
- Patellofemoral brace: Keeps the kneecap aligned and reduces pain during movement.
- Compression brace: Reduces swelling, improves blood flow, and provides mild joint support during recovery.
- Knee immobilizer: Keeps the knee fully straight to prevent movement and protect the fracture during early healing
How Does PRP Therapy Help Tibial Healing?
In PRP therapy, your doctor may use your own blood components to support and enhance the healing process of the tibia. First, the doctor draws a small amount of blood and centrifuges it to concentrate the platelets. These platelets contain growth factors that play an important role in tissue repair and regeneration.
After that, the doctor injects the platelet-rich plasma directly into or around the injured area, depending on the fracture pattern and stage of healing. This targeted injection helps activate the body’s natural repair response at the fracture site, promotes new cell growth, and improves blood circulation. In addition, PRP therapy may help reduce inflammation and decrease pain in the knee ligaments, such as:
- Anterior cruciate ligament (ACL)
- Posterior cruciate ligament (PCL)
- Medial collateral ligament (MCL)
- Lateral collateral ligament (LCL)
How Long Does It Take To Recover From a Knee Fracture?
Most patients recover from a knee fracture in 3 to 6 months, depending on the severity of the injury, the treatment method, and the overall health. In the first 6 to 12 weeks, the bone begins to heal and stabilize. During this early phase, Dr. Michael K. Shindle may recommend a cast or brace to support the healing bone. By 3–4 months, you may regain partial strength and an improved range of motion in the knee. However, in more complex cases, full recovery may take longer than 6 months due to extensive joint damage.
Can Electrical Stimulation Help With Recovery?
Yes, electrical stimulation can significantly support recovery after a knee injury, such as a tibial fracture. This treatment uses mild electrical impulses to activate muscles around the knee, which helps prevent muscle weakness after injury or surgery. Electrical stimulation also improves circulation in the blood vessels and surrounding tissues, which can support healing and reduce stiffness. In some cases, it may help reduce pain and improve muscle control during early recovery.
Visit Total Orthopedics & Sports Medicine for Tibial Plateau Fracture Treatment in Clifton!
If you have a tibial plateau fracture, you may experience persistent knee pain along with swelling, stiffness, and difficulty bearing weight on the affected leg. In these cases, even basic movements like walking, bending the knee, or standing for long periods can become challenging.
As an orthopedic consultant for the New York Football Giants, our surgeon, Dr. Michael K. Shindle, at Total Orthopedics and Sports Medicine, uses athlete-level evaluation and treatment methods to manage complex knee injuries, including tibial plateau fractures. During recovery, he also guides you through activity modification, strengthening exercises, and progressive exercise programs designed to restore knee stability. Call 855-321-6784 or visit us at 925 Clifton Ave, Clifton, NJ 07013, USA to book your appointment.
FAQs
What Happens if a Tibial Plateau Fracture Is Left Untreated?
If a tibial plateau fracture is left untreated, the bone may heal in a misaligned position, which can permanently affect knee function and stability. Without proper treatment, the injury can also cause chronic knee instability, persistent swelling, and difficulty bearing weight.
Do All Tibial Fractures Require Surgery?
No, not all tibial fractures require surgery. Treatment depends on the type, location, and severity of the fracture. If the fracture is stable and non-displaced, Dr. Michael K. Shindle may recommend non-surgical treatment. However, surgery may be needed if the fracture is displaced or unstable.
How Long Does Swelling Last After a Knee Fracture?
Swelling after a tibial fracture usually lasts 1-6 weeks, and in more severe injuries, it can persist for a few months. In the first 1–2 weeks, swelling is typically most prominent due to inflammation. Over the 3–6 weeks, swelling gradually reduces as the bone begins to heal.
What Activities Should I Avoid During Recovery?
During recovery, avoid deep squatting, running, jumping, and sudden twisting, as these movements can strain the injured area. Also, avoid high-impact sports such as basketball, tennis, and football to protect the knee joint. Moreover, do not lift heavy weights while bending the knee, and avoid climbing stairs repeatedly.
How Painful Is a Tibial Plateau Fracture?
A tibial plateau fracture is usually extremely painful, especially at the time of injury. You may feel sharp pain around your knee, along with immediate swelling and difficulty bearing weight on the leg. The pain often increases when you try to move your knee, stand, or walk.
