Assessment of post-traumatic osteoarthritis following tibial pilon fracture using weight bearing computed tomography

Osteoarthritis is one of the most common disabling conditions, affecting over 50 million people in the United States. Serious joint injuries often cause a type of osteoarthritis called post-traumatic osteoarthritis (PTOA), which can develop within several years after injury. Pilon fractures of the distal tibia particularly predispose the ankle to PTOA, with over 50% of patients suffering from PTOA within five years of injury. However, it is not known which patients will develop this condition and which will remain healthy.

As new potential treatments for preventing PTOA arise, testing of their efficacy would be greatly accelerated by capabilities for early detection. Thus, there is a need for an early objective indicator for PTOA risk in patients recovering from tibial pilon fractures.

This study improved upon existing methods for monitoring PTOA progression and prediction. A computational model was developed to predict PTOA risk in the ankle. This model used 3D ankle scans acquired from a weight bearing CT scanner and custom-written code to compute contact stresses in the ankle. We found a relationship between increased contact stresses and PTOA development in the ankle, which allowed us to make predictions about the long-term outcomes of these patients.

Early prediction for future changes in the joint helps us prescribe the most effective treatment, which provides a basis to prevent permanent damage to the cartilage and preserve long-term joint function.