Post-traumatic arthritis (PTAr) is a form of
osteoarthritis following an injury to a joint.[1]
Classification
Post-traumatic arthritis is a form of
osteoarthritis and the former can occur after the latter. However, post-traumatic arthritis can also occur after the development of chronic inflammatory arthritis.
Generally, post-traumatic arthritis is classified in two groups: post-traumatic osteoarthritis and post-traumatic inflammatory arthritis.[2]
Post-traumatic osteoarthritis
Post-traumatic osteoarthritis is the most common variation of post-traumatic arthritis.[3] Between 20 and 50%[4] of all osteoarthritis cases are preceded by post-traumatic arthritis. Patients having post-traumatic osteoarthritis are usually younger than osteoarthritis patients without any previous physical injuries.[5]
As a result of these symptoms, post-traumatic arthritis often comes along with the
loss of ability.
Risk factors
Since post-traumatic arthritis usually occurs after injuring a joint, the risk of having post-traumatic arthritis after such an injury is significantly higher.
Risk factors which increase the danger of getting post-traumatic arthritis are being
overweight and
physical activity.[12] The prevalence of post-traumatic arthritis is much higher when doing heavy work and overusing the injured joints.
Examinations also revealed that a
body mass index (BMI) increase of five units results in a 35% higher risk of post-traumatic arthritis.[13]
It is reported that
genetics do have an influence on the prevalence of post-traumatic arthritis.[14][15] According to newer examinations, the sex of the patients may also have an influence on post-traumatic arthritis, since females are affected by post-traumatic arthritis more frequently than males.[16]
Pathogenesis
The process of post-traumatic arthritis can be divided into three phases: immediate, acute, and chronic.[1][17]
The chronic phase occurs months or years after the trauma. Typical symptoms are
joint pain and dysfunction.[1][12]
Diagnosis
Post-traumatic arthritis is diagnosed with the help of a patient's
medical history. Additionally,
radiographicimaging can assist in diagnosing post-traumatic arthritis.[20]
Management
It is not possible to cure the acute post-traumatic arthritis in order to prevent a chronic post-traumatic arthritis.[1] There are many different options to manage chronic post-traumatic arthritis.[12]
Lifestyle
Since being overweight is a risk factor for post-traumatic arthritis, lifestyle changes that help manage
body weight are important in the treatment and prevention of the condition. Lifestyle changes and
weight loss often involve educating the affected person about how to practice a healthy lifestyle.[21]
If medications, lifestyle changes, and physical therapy are not enough to reduce the symptoms, especially the pain, surgery and other such interventions for managing post-traumatic arthritis are available. In many cases,
joint replacement or
cartilage resurfacing are recommended. As clinical studies have demonstrated, such surgical methods can be effective at reducing symptomatic pain[28][29] and the costs associated with management of the condition.[30][31]
Epidemiology
About 12% of all
osteoarthritis cases in the
United States are classified as post-traumatic osteoarthritis.[2] This means that over 5.6 million people are affected by post-traumatic osteoarthritis only in the United States.[2]
Females are more often affected than males.[16]
Post-traumatic arthritis costs the
US health care system approximately US$3.06 billion (0.15%) of total health care costs each year.[2]
^
abcdBrown, Thomas D.; Johnston, Richard C.; Saltzman, Charles L.; Marsh, J. Lawrence; Buckwalter, Joseph A. (November 2006). "Posttraumatic Osteoarthritis: A First Estimate of Incidence, Prevalence, and Burden of Disease". Journal of Orthopaedic Trauma. 20 (10): 739–44.
doi:
10.1097/01.bot.0000246468.80635.ef.
PMID17106388.
^Gelber, A. C.; Hochberg, M. C.; Mead, L. A.; Wang, N. Y.; Wigley, F. M.; Klag, M. J. (2000-09-05). "Joint injury in young adults and risk for subsequent knee and hip osteoarthritis". Annals of Internal Medicine. 133 (5): 321–328.
doi:
10.7326/0003-4819-133-5-200009050-00007.
PMID10979876.
^Söderlin, Maria K.; Bergsten, Ulrika; Svensson, Björn; BARFOT Study Group (March 2011). "Patient-reported events preceding the onset of rheumatoid arthritis: possible clues to aetiology". Musculoskeletal Care. 9 (1): 25–31.
doi:
10.1002/msc.193.
PMID21351367.
^Punzi, L.; Pianon, M.; Bertazzolo, N.; Fagiolo, U.; Rizzi, E.; Rossini, P.; Todesco, S. (May 1998). "Clinical, laboratory and immunogenetic aspects of post-traumatic psoriatic arthritis: a study of 25 patients". Clinical and Experimental Rheumatology. 16 (3): 277–281X.
PMID9631749.
^Jiang L, Tian W, Wang Y, Rong J, Bao C, Liu Y, Zhao Y, Wang C (May 2012). "Body mass index and susceptibility to knee osteoarthritis: a systematic review and meta-analysis". Joint Bone Spine. 79 (3): 291–7.
doi:
10.1016/j.jbspin.2011.05.015.
PMID21803633.
^Bierma-Zeinstra, Sita M. A.; Oster, J. Dorinde; Bernsen, Roos M. D.; Verhaar, Jan A. N.; Ginai, Abida Z.; Bohnen, Arthur M. (August 2002). "Joint space narrowing and relationship with symptoms and signs in adults consulting for hip pain in primary care". The Journal of Rheumatology. 29 (8): 1713–1718X.
PMID12180735.
^
abWang, Shi-Yi; Olson-Kellogg, Becky; Shamliyan, Tatyana A.; Choi, Jae-Young; Ramakrishnan, Rema; Kane, Robert L. (2012-11-06). "Physical Therapy Interventions for Knee Pain Secondary to Osteoarthritis: A Systematic Review". Annals of Internal Medicine. 157 (9): 632–44.
doi:
10.7326/0003-4819-157-9-201211060-00007.
PMID23128863.
^
abDe Luigi, Arthur Jason (May 2012). "Complementary and alternative medicine in osteoarthritis 1". PM&R: The Journal of Injury, Function, and Rehabilitation. 4 (5 Suppl): S122–133.
doi:
10.1016/j.pmrj.2012.01.012.
PMID22632691.
^
abFrench, H. P.; Brennan, A.; White, B.; Cusack, T. (April 2011). "Manual therapy for osteoarthritis of the hip or knee – A systematic review". Manual Therapy. 16 (2): 109–117.
doi:
10.1016/j.math.2010.10.011.
PMID21146444.
^Carr, Andrew J; Robertsson, Otto; Graves, Stephen; Price, Andrew J; Arden, Nigel K; Judge, Andrew; Beard, David J (2012-04-07). "Knee replacement". The Lancet. 379 (9823): 1331–40.
doi:
10.1016/S0140-6736(11)60752-6.
PMID22398175.
^Jenkins, P. J.; Clement, N. D.; Hamilton, D. F.; Gaston, P.; Patton, J. T.; Howie, C. R. (January 2013). "Predicting the cost-effectiveness of total hip and knee replacement: a health economic analysis". The Bone & Joint Journal. 95-B (1): 115–121.
doi:
10.1302/0301-620X.95B1.29835.
PMID23307684.