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| IJCEM Copyright © 2008-All rights reserved. Published by e-Century Publishing Corporation, Madison, WI 53711 |
Int J Clin Exp Med 2011;4(4):285-298
Review Article
Pathogenetic mechanisms of posttraumatic osteoarthritis: opportunities for early
intervention
William C Kramer, Kelly J Hendricks, Jinxi Wang
Department of Orthopedic Surgery, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, Kansas 66160, USA
Received October 1, 2011; accepted October 16, 2011; Epub October 21, 2011; Published November 30, 2011
Abstract: Osteoarthritis (OA) is characterized by joint pain and stiffness with radiographic evidence of joint space narrowing,
osteophytes, and subchondral bone sclerosis. Posttraumatic OA (PTOA) arises from joint trauma, which accounts for a fraction of all
patients with OA. Articular cartilage breakdown can occur soon or for years after a joint injury. Even with the current care of joint injuries,
such as anatomic reduction and rigid fixation of intra-articular fractures and reconstruction of ruptured ligaments with successful
restoration of joint biomechanics, the risk of PTOA after joint injuries ranges from 20% to more than 50%. The time course for the
progression of PTOA is highly variable and risk of PTOA increases with patient age at the time of joint injury, suggesting that biologic
factors may be involved in the progression of PTOA. Therapeutic options are limited due largely to the lack of information on the
mechanisms underlying the progression of PTOA. This review summarizes the current studies on the pathogenetic mechanisms of
PTOA, with a main focus on the metabolic changes in articular cartilage in the acute posttraumatic phase and the early chronic phase,
a clinically asymptomatic period. Recent studies have revealed that mechanical damage to the articular tissues may lead to changes in
gene expression and cartilage metabolism, which could trigger a cascade of events leading to degradation of articular cartilage and
pathologic changes in other joint tissues. Understanding the mechanobiologic, molecular and cellular changes that lead to continued
cartilage degradation in the relatively early phases after joint injury may open up new opportunities for early clinical
intervention.(IJCEM1110001).
Key words: Osteoarthritis, posttraumatic osteoarthritis, joint injury, articular cartilage, meniscus, ligament
Full Text PDF
Address all correspondence to:
Dr. Jinxi Wang
Department of Orthopedic Surgery
University of Kansas Medical Center
MS 3017, 3901 Rainbow Boulevard
Kansas City, Kansas 66160, USA.
Tel: 913-588-0870; Fax: 913-945-7773
E-mail: jwang@kumc.edu
Review Article
Pathogenetic mechanisms of posttraumatic osteoarthritis: opportunities for early
intervention
William C Kramer, Kelly J Hendricks, Jinxi Wang
Department of Orthopedic Surgery, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, Kansas 66160, USA
Received October 1, 2011; accepted October 16, 2011; Epub October 21, 2011; Published November 30, 2011
Abstract: Osteoarthritis (OA) is characterized by joint pain and stiffness with radiographic evidence of joint space narrowing,
osteophytes, and subchondral bone sclerosis. Posttraumatic OA (PTOA) arises from joint trauma, which accounts for a fraction of all
patients with OA. Articular cartilage breakdown can occur soon or for years after a joint injury. Even with the current care of joint injuries,
such as anatomic reduction and rigid fixation of intra-articular fractures and reconstruction of ruptured ligaments with successful
restoration of joint biomechanics, the risk of PTOA after joint injuries ranges from 20% to more than 50%. The time course for the
progression of PTOA is highly variable and risk of PTOA increases with patient age at the time of joint injury, suggesting that biologic
factors may be involved in the progression of PTOA. Therapeutic options are limited due largely to the lack of information on the
mechanisms underlying the progression of PTOA. This review summarizes the current studies on the pathogenetic mechanisms of
PTOA, with a main focus on the metabolic changes in articular cartilage in the acute posttraumatic phase and the early chronic phase,
a clinically asymptomatic period. Recent studies have revealed that mechanical damage to the articular tissues may lead to changes in
gene expression and cartilage metabolism, which could trigger a cascade of events leading to degradation of articular cartilage and
pathologic changes in other joint tissues. Understanding the mechanobiologic, molecular and cellular changes that lead to continued
cartilage degradation in the relatively early phases after joint injury may open up new opportunities for early clinical
intervention.(IJCEM1110001).
Key words: Osteoarthritis, posttraumatic osteoarthritis, joint injury, articular cartilage, meniscus, ligament
Full Text PDF
Address all correspondence to:
Dr. Jinxi Wang
Department of Orthopedic Surgery
University of Kansas Medical Center
MS 3017, 3901 Rainbow Boulevard
Kansas City, Kansas 66160, USA.
Tel: 913-588-0870; Fax: 913-945-7773
E-mail: jwang@kumc.edu
