The pathomechanical etiology of post-traumatic osteoarthritis following intraarticular fractures

Donald D Anderson; J Lawrence Marsh; Thomas D Brown

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$The pathomechanical etiology of post-traumatic osteoarthritis following intraarticular fractures$

Journal article

Open access

Peer reviewed

The pathomechanical etiology of post-traumatic osteoarthritis following intraarticular fractures

Donald D Anderson, J Lawrence Marsh and Thomas D Brown

The Iowa orthopaedic journal, Vol.31, pp.1-20

2011

PMCID: PMC3215107

PMID: 22096414

Appears in Diamond Open Access

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3215107/View

Published (Version of record) Open Access

Abstract

Many intra-articular fracture patients eventually experience significant functional deficits, pain, and stiffness from post-traumatic osteoarthritis (PTOA). Over the last several decades, continued refinement of surgical reconstruction techniques has failed to markedly improve patient outcomes. New treatment paradigms are needed - ideally, bio/pharmaceutical. Progress in that direction has been impeded because the pathomechanical etiology of PTOA development is poorly understood. In particular, the relative roles and pathomechanisms of acute joint injury (from the initial trauma) versus chronic contact stress elevation (from residual incongruity) are unknown, primarily because there have been no objective methods for reliably quantifying either of these insult entities. Over the past decade, novel enabling technologies have been developed that provide objective biomechanical indices of injury severity and of chronic contact stress challenge to fractured joint surfaces. The severity of the initial joint injury is indexed primarily on the basis of the energy released in fracture, obtained from validated digital image analysis of CT scans. Chronic contact stress elevations are indexed by patient-specific finite element stress analysis, using models derived from post-reduction CT scans. These new measures, conceived in the laboratory, have been taken through the stage of validation, and then have been applied in studies of intra-articular fracture patients, to relate these biomechanical indices of cartilage insult to the incidence and severity of PTOA This body of work has provided a novel framework for developing and testing new approaches to forestall PTOA following intra-articular fractures.

Intra-Articular Fractures - physiopathology

Humans

Wounds and Injuries - complications

Stress, Mechanical

Trauma Severity Indices

Wounds and Injuries - physiopathology

Joints - physiopathology

Osteoarthritis - physiopathology

Weight-Bearing - physiology

Joints - injuries

Cartilage, Articular - physiopathology

Models, Biological

Computer Simulation

Fractures, Bone - complications

Fractures, Bone - physiopathology

Cartilage, Articular - injuries

Intra-Articular Fractures - complications

Osteoarthritis - etiology

Details

Title: Subtitle: The pathomechanical etiology of post-traumatic osteoarthritis following intraarticular fractures
Creators: Donald D Anderson - Department of Orthopaedics, The University of Iowa, Iowa City, IA, USA. don-anderson@uiowa.edu
J Lawrence Marsh
Thomas D Brown
Resource Type: Journal article
Publication Details: The Iowa orthopaedic journal, Vol.31, pp.1-20
Publisher: Dept. of Orthopaedics, The University of Iowa; United States
PMID: 22096414
PMCID: PMC3215107
ISSN: 1541-5457
eISSN: 1555-1377
Grant note: AR054015 / NIAMS NIH HHS P50 AR055533 / NIAMS NIH HHS P50 AR048939 / NIAMS NIH HHS R24 AR046601 / NIAMS NIH HHS AR055533 / NIAMS NIH HHS AR048939 / NIAMS NIH HHS AR046601 / NIAMS NIH HHS R01 AR046601 / NIAMS NIH HHS R21 AR054015 / NIAMS NIH HHS
Language: English
Date published: 2011
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Orthopedics and Rehabilitation; Industrial and Systems Engineering
Record Identifier: 9984040205602771

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