Post-Traumatic Arthritis After Missouri Crash

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Post-traumatic arthritis (PTA) frequently develops following a joint injury, a meniscal or ligament tear or an intra-articular fracture. Exactly why this happens and the mechanisms by which it develops historically have been poorly understood. Now researchers at the University of Texas-Dallas Medical School, believe they have uncovered some preliminary answers that could lead to a better understanding and one day be used to prevent PTA

Osteoarthritis and Post-Traumatic Arthritis

The research team, led by Dr. Joseph Borrelli, M.D., Professor and Chairman of Orthopaedic Surgery, used animal models to study what happens to articular cartilage following trauma. The research team examined the articular cartilage—the smooth white tissues that cover the end of bones—of injured femoral joints in rabbits at one month; and again at six months, post-trauma.
After one month, they found that the cartilage already showed signs of thinning; after six months, the thinning had worsened. CT imaging of the joints revealed a pattern of increased bone density, reducing the shock-absorbing capacity of underlying bone, making it more vulnerable to subsequent degenerative disease or injury.
One of the research team’s most surprising findings was that the chondrocytes—the building blocks that produce and maintain the distinctive matrix structure found in healthy cartilage—did not disappear or die but instead stopped producing the substances needed to maintain the tissue’s structural integrity.
This process is distinctly different than what occurs in osteoarthritis where the chrondocytes go into overdrive mode in an attempt to maintain the cartilage and eventually burn out.
Dr. Borrelli was careful to point out that osteoarthritis may still develop in cases of PTA. Findings of the study also appear to show that a single trauma to the cartilage without a fracture can induce PTA:
“This may explain why PTA sometimes develops very quickly in patients after an injury. PTA can develop in just six months—unlike osteoarthritis, which may take up to 60 years to develop.”
This distinction is particularly important as it is estimated that 10-15% of the population diagnosed with osteoarthritis are actually suffering from PTA.

Implications for Future Treatment

Dr. Borrelli believes that the findings from this research could someday lead to a method for repairing injured cartilage before PTA has done irreparable damage. Since the chondrocytes are still alive in the early aftermath of an injury, it may be possible to stimulate or “awaken” them through an injection or a systemic delivery system.
First, though, further research is needed to more fully define the mechanism by which deterioration of the cartilage occurs following an injury. Dr. Borrelli points to the major advances that have occurred in the treatment of rheumatoid arthritis over the last ten years. He hopes that his team’s ongoing research could eventually lead to promising answers and early treatment of PTA.

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