Ankle osteoarthritis: Toward new understanding and opportunities for prevention and intervention.

Autor: Anderson DD; Department of Orthopedics & Rehabilitation, The University of Iowa, Iowa City, Iowa, USA.; Department of Biomedical Engineering, The University of Iowa, Iowa City, Iowa, USA.; Department of Industrial and Systems Engineering, The University of Iowa, Iowa City, Iowa, USA., Ledoux WR; Center for Limb Loss and MoBility (CLiMB), VA Puget Sound Health Care System, Seattle, Washington, USA.; Departments of Mechanical Engineering and Orthopaedics & Sports Medicine, University of Washington, Seattle, Washington, USA., Lenz AL; Department of Orthopaedics, University of Utah, Salt Lake City, Utah, USA.; Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah, USA., Wilken J; Department of Physical Therapy and Rehabilitation Science, The University of Iowa, Iowa City, Iowa, USA., Easley ME; Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina, USA., de Cesar Netto C; Department of Orthopedics & Rehabilitation, The University of Iowa, Iowa City, Iowa, USA.; Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina, USA.
Jazyk: angličtina
Zdroj: Journal of orthopaedic research : official publication of the Orthopaedic Research Society [J Orthop Res] 2024 Dec; Vol. 42 (12), pp. 2613-2622. Date of Electronic Publication: 2024 Sep 13.
DOI: 10.1002/jor.25973
Abstrakt: The ankle infrequently develops primary osteoarthritis (OA), especially when compared to the hip and the knee. Ankle OA instead generally develops only after trauma. The consequences of end-stage ankle OA can nonetheless be extremely debilitating, with impairment comparable to that of end-stage kidney disease or congestive heart failure. Disconcertingly, evidence suggests that ankle OA can develop more often than is generally appreciated after even low-energy rotational ankle fractures and chronic instability associated with recurrent ankle sprains, albeit at a slower rate than after more severe trauma. The mechanisms whereby ankle OA develops after trauma are poorly understood, but mechanical factors are implicated. A better understanding of the prevalence and mechanical etiology of post-traumatic ankle OA can lead to better prevention and mitigation. New surgical and conservative interventions, including improved ligamentous repair strategies and custom carbon fiber bracing, hold promise for advancing treatment that may prevent residual ankle instability and the development of ankle OA. Studies are needed to fill in key knowledge gaps here related to etiology so that the interventions can target key factors. New technologies, including weight bearing CT and biplane fluoroscopy, offer fresh opportunities to better understand the relationships between trauma, ankle alignment, residual ankle instability, OA development, and foot/ankle function. This paper begins by reviewing the epidemiology of post-traumatic ankle OA, presents evidence suggesting that new treatment options might be successful at preventing ankle OA, and then highlights recent technical advances in understanding of the origins of ankle OA to identify directions for future research.
(© 2024 The Author(s). Journal of Orthopaedic Research® published by Wiley Periodicals LLC on behalf of Orthopaedic Research Society.)
Databáze: MEDLINE
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