A Computational Framework for Custom Orthosis Prescription to Reduce Post-Traumatic Osteoarthritis Risk

Osteoarthritis (OA) is a highly debilitating disease that affects around 27 million people. Post-traumatic osteoarthritis (PTOA) is a specific type of OA that occurs in joints after a joint injury such as a bone fracture involving the joint. PTOA accounts for about 12% of cases of OA. PTOA is disabling and can significantly hinder the quality of life for persons with the disease. For those with ankle fractures, PTOA can hinder their ability to walk, and perform normal functions. Ankle fractures that occur from an event such as a car crash or a fall from a significant height, can fracture the leg in a direct impact collision, and leave the lower leg bone in multiple pieces. Skilled surgeons can repair this fracture, however the bone is rarely, if ever, put back together perfectly. Even with a close, but imperfectly fixed fracture, PTOA can still develop. A custom ankle brace, called a custom dynamic orthosis (CDO), can help relieve the pain remaining after the ankle fracture and alleviate some of the contact stress that occurs in the ankle joint which can progress PTOA. Our CDO provides some weight offloading through a cuff attached below the knee, a strut behind the leg, and a footplate that inserts below the foot and into a patient’s shoe. This CDO has been shown to reduce the stress experienced at the ankle joint in patients who are at risk for development of PTOA. Through computer modeling software and stress analysis code, we can analyze specific ankle joint injuries and customize the CDO to most effectively prevent PTOA in the ankle. This CDO is intended for daily wear and will provide pain and stress relief in the ankle while also mitigating PTOA development in the ankle joint of persons with a previous ankle fracture.