Incongruity versus Instability in the Etiology of Posttraumatic Arthritis
| Autor: | Thomas D. Brown, Todd O. McKinley, M. James Rudert, Daniel C Koos |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Cartilage
Articular Joint Instability medicine.medical_specialty business.industry Cartilage Posttraumatic arthritis General Medicine Articular surface Instability Weight-Bearing Transient stress Physical medicine and rehabilitation medicine.anatomical_structure Osteoarthritis Cadaver medicine Etiology Humans Orthopedics and Sports Medicine Surgery Ankle Injuries Ankle business Cartilage damage |
| Zdroj: | Clinical Orthopaedics & Related Research. 423:44-51 |
| ISSN: | 0009-921X |
| DOI: | 10.1097/01.blo.0000131639.89143.26 |
| Popis: | The etiology of posttraumatic arthritis is understood poorly but it clearly has a pathomechanical component. Posttraumatic arthritis likely results from irreversible cartilage damage sustained at the time of injury and chronic cartilage overloading resulting from articular incongruity and instability. However, the relative importance of instability and incongruity is unknown. Clinical studies show that the hip, knee, and ankle tolerate incongruity differently. However, all three joints poorly tolerate instability. Basic mechanical studies have shown that static loading of articular surface incongruities have caused relatively modest increases in contact pressure. However, static testing poorly replicates normal viscoelastic properties of cartilage, which may mask important transient stress elevations that occur during motion. Static tests also ignore potential abnormal loads that may accumulate throughout a motion cycle. We review the clinical and basic scientific evidence linking incongruity and instability to posttraumatic arthritis. Preliminary data from a newly developed dynamic ankle testing device are presented. Dynamic testing allows measurement of transient contact loads and loading rates that occur through the entire motion cycle and it opens the door to measure mechanical abnormalities associated with instability. |
| Databáze: | OpenAIRE |
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