Utilizing weight bearing CT to explore predictors of post-traumatic osteoarthritis risk after tibial pilon fracture

Post-traumatic osteoarthritis (PTOA) is a painful joint condition that can occur after traumatic injury. Injuries to joints of the lower extremity most commonly result in PTOA, affecting over 5 million people in the United States alone. Individuals with PTOA experience disabling joint pain, stiffness, and decreased function. Reductions in mental health and sleep quality are also associated with PTOA.

Pilon fractures are high-energy tibial fractures that occur near the ankle and are often caused by falls or motor vehicle accidents. These injuries provide opportunities to learn more about how PTOA progresses as they are associated with high rates of PTOA development in a relatively short time frame after injury.

The goal of this project was to improve early detection of PTOA by exploring relationships between variables used to determine joint health and later indications of PTOA development. By identifying early signs of PTOA, clinical treatments aimed at preventing disease progression can be improved.

Computational modeling approaches were used to measure fracture energy, joint space width (JSW), and chronic contact stress exposures for fractured ankles. Modifications made to these modeling approaches improved JSW measurement accuracy and were used to determine the repeatability of measurement techniques. Relationships were found between early measurements and subsequent joint changes associated with PTOA development. This work provides a basis for additional early detection analyses.