Sabatini L, Aprato A, Camazzola D, et al. - Researchers obtained age, gender, mechanism of trauma, pre-operative autonomy level, fractures classification, degree of osteoarthritis, and intraoperative data (ligamentous stability and type of implant). They assessed the Knee Society Score, post-operative autonomy level, and Forgotten Joint Score after a mean follow-up of 28 months. The further recorded radiological assessment (signs of loosening, limb axis, and patellar height indices) and complications. This study’s findings demonstrated that in the case of tibial plateau fractures, primary total knee arthroplasty (TKA) is a suitable option in elderly patients with pre-existing osteoarthritis and poor bone quality, in which osteosynthesis outcome may be poor. According to the findings, unlike ORIF, primary TKA may allow immediate weight-bearing and a faster recovery. However, it is a required surgery with a significant complication rate and should be reserved for selected patients and experienced surgeons.