Journal article
IS ELEVATED CONTACT STRESS PREDICTIVE OF POST-TRAUMATIC OSTEOARTHRITIS FOR IMPRECISELY REDUCED TIBIAL PLAFOND FRACTURES?
Journal of orthopaedic research, Vol.29(1), pp.33-39
01/2011
DOI: 10.1002/jor.21202
PMCID: PMC2972368
PMID: 20607840
Abstract
Despite the widely held belief that residual incongruities from intra-articular fractures subject the joint to contact stresses that predispose to post-traumatic osteoarthritis (PTOA), objective evidence has been lacking. This study tested the hypothesis that a metric of elevated contact stress exposure would predict the onset of PTOA. The ankles of ten tibial plafond fracture patients were treated initially using a spanning fixator, with subsequent screw fixation of the articular surface. Following up on an earlier report of finite element computed post-operative contact stress distributions in these patients’ ankles, Kellgren-Lawrence (KL) scores were assessed from minimum two-year follow-up radiographs to characterize the presence/severity of PTOA. At that time point, seven patients had developed PTOA (KL ≥ 2). Five different metrics of contact stress exposure were calculated, all of which exhibited excellent concordance with KL scores, ranging from 88% to 95%. When time of stress exposure was included, one metric was able to predict PTOA development (KL ≥ 2) with 100% reliability, and all metrics exhibited greater than 94% prediction reliability. These findings, albeit in a small population, support the existence of a contact stress exposure threshold above which incongruously reduced tibial plafond fractures are highly likely to develop PTOA.
Details
- Title: Subtitle
- IS ELEVATED CONTACT STRESS PREDICTIVE OF POST-TRAUMATIC OSTEOARTHRITIS FOR IMPRECISELY REDUCED TIBIAL PLAFOND FRACTURES?
- Creators
- Donald D Anderson - Department of Orthopaedics and Rehabilitation, The University of Iowa, 2181 Westlawn Building, Iowa City, IA 52242Christopher Van Hofwegen - Department of Orthopaedics and Rehabilitation, The University of Iowa, 2181 Westlawn Building, Iowa City, IA 52242J. Lawrence Marsh - Department of Orthopaedics and Rehabilitation, The University of Iowa, 2181 Westlawn Building, Iowa City, IA 52242Thomas D Brown - Department of Orthopaedics and Rehabilitation, The University of Iowa, 2181 Westlawn Building, Iowa City, IA 52242
- Resource Type
- Journal article
- Publication Details
- Journal of orthopaedic research, Vol.29(1), pp.33-39
- DOI
- 10.1002/jor.21202
- PMID
- 20607840
- PMCID
- PMC2972368
- ISSN
- 0736-0266
- eISSN
- 1554-527X
- Language
- English
- Date published
- 01/2011
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Orthopedics and Rehabilitation; Industrial and Systems Engineering
- Record Identifier
- 9984040015802771
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