HOT TOPIC: New Innovations in the Diagnosis and Management of Posttraumatic Osteoarthritis

Abstract

Posttraumatic osteoarthritis after acute joint injury is a common and significant health issue that can cause severe disability in affected individuals. The disease may occur following a variety of joint injuries, but is most predictable secondary to fractures of the articular surface, particularly severe high-energy fractures. To minimize the long-term mechanical effects of joint incongruity, surgeons reduce and stabilize fractures using concepts and techniques that have been developed and refined over decades. Despite these efforts, however, posttraumatic osteoarthritis remains common, and further advances to improve surgical reduction or fixation techniques are unlikely to appreciably change the prognosis. Although posttraumatic osteoarthritis is initiated by physical damage, biologic responses contribute decisively to the progression of the disease process, suggesting that it may be treatable with drugs that target biologic responses. Controlled clinical trials are needed to realize the potential of these drugs. In addition, advances in imaging now allow assessment of the mechanical and biologic aspects of injury and treatment in ways not previously possible, opening the door for new clinical investigations to enhance the understanding and treatment of this complex disease.

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