The Genetic, Mechanical, and Inflammatory Components of Posttraumatic Osteoarthritis

Abstract

Joint trauma affects all joint tissues to some extent, and in the case of the knee, there is a critical need for rigorous clinical and laboratory studies to define the factors responsible for joint deterioration associated with injury of the meniscus or anterior cruciate ligament. Posttraumatic osteoarthritis constitutes a subtype of osteoarthritis in which the end stage of the disease may be very similar but the initial causes, stages of development and progression, patient populations, and potential approaches to treatment may be viewed as quite different. General risk factors for the pathogenesis of osteoarthritis, but particularly for posttraumatic osteoarthritis, include biomechanical instability of the affected joint, and inflammation. Understanding how to prevent synovial inflammation and cartilage damage during the days and weeks after injury, before irreversible progression of joint pathology begins, may provide a window of opportunity for diagnosis at an early stage of posttraumatic osteoarthritis and for evaluation of the risk of its progression. Studies of tissues and fluids taken at the time of arthroscopic surgery, and subsequent evaluation of longitudinal postoperative outcome data, may permit the identification of surrogate markers with predictive value in defining postoperative outcomes, and permit testing and implementation of novel treatments to halt or slow the development of posttraumatic osteoarthritis.

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