Post-traumatic osteoarthritis (PTOA) is a common form of osteoarthritis that might occur after any joint trauma. Most PTOA publications mainly focus on anterior cruciate ligament (ACL) injuries. However, many other traumatic injuries are associated with PTOA, not only for the knee but also for the hip joint. We aim to identify and summarize the existing literature on the musculoskeletal injuries associated with knee and hip PTOA and their risk factors in determining those with a worse prognosis, excluding ACL injuries. Despite the narrative nature of this review, a systematic search for published studies in the last twenty years regarding the most relevant injuries associated with a higher risk of PTOA and associated risk factors for OA was conducted. This review identified the six more relevant injuries associated with knee or hip PTOA. We describe the incidence, risk factors for the injury and risk factors for PTOA of each. Meniscal injury, proximal tibial fracture, patellar dislocation, acetabular, femoral fractures and hip dislocations are all discussed in this review.

Background The estimated prevalence of post-traumatic osteoarthritis (PTOA) is 10–12% and in this study 12.4%. Different knee and hip injuries have been identified as risk factors for PTOA, but there is no consensus regarding the most painful and disabling injuries. Identifying these injuries might help in the prevention of PTOA. Additionally, patients with PTOA have a higher risk for complications after arthroplasty than patients with primary OA, perhaps due to differences in the profile and comorbidity that might help to explain the difference. This work aims 1) to identify the most common past injuries associated with the most painful and disabling PTOA cases in non-athlete patients and 2) to compare the comorbidities and characteristics between PTOA and primary OA. Methods Retrospective hospital-based cohort study with 1290 participants with joint complaints or who received arthroplasty. Medical records included demographic information, diagnosis, medication, smoking, alcohol history and comorbidities. Data from January 2012 orthopaedic consults till December 2019 was reviewed and had the type and date of injury, pain score by the numerical rating scale and walking disability. Odds Ratio (OR) and 95% confidence intervals are presented. Results There were 641 cases with primary OA (65% females) and 104 with PTOA (61% males). Patients with PTOA were 7.5 years younger (P < 0.001), reported more alcohol consumption (P = 0.01) and had higher odds of osteoporotic fractures (OP) and psychosis than patients with primary OA (OR = 2.0, CI = 1.06–3.78 and OR = 2.90, CI = -0.91–9.18, respectively). Knee fractures were most common in males and hip fractures in females (31% and 37.5%, respectively, P < 0.005). The PTOA-associated injuries with the highest pain and disability scores were meniscal injuries and hip fractures. Besides, in the group with primary OA, there were more diabetes, hypertension and hypothyroidism cases than in PTOA. However, after adjustment, differences were only significant for diabetes (ORadj = 1.78, CI = 1.0–3.2). Conclusions Past meniscal injuries and hip fractures were the most relevant PTOA-associated injuries regarding pain and walking disability. This, together with differences in their profile when compared with primary OA, might help to decide the orthopaedic management of these injuries to prevent complications such as PTOA and recurrence, with appropriate preoperative planning, surgery choice and comorbidity treatment.

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Purpose: Osteoarthritis (OA) has been usually defined as a painful joint disease that predominantly affects elderly. However, the degree of pain that patients with OA experiment vary considerably and do not always correspond with the severity of structural changes. This is in part explained by multiple mechanisms that might contribute to pain perception in OA . Comorbidity is considered one of those mechanisms. However, in the search for OA-phenotypes, comorbidity has been used in general as an index or sum of different diseases that do not always contribute to modify pain perception. Different phenotypes have been previously explored to understand the genesis of pain in OA. Metabolic, neuropathic and Inflammatory, are some of the most studied. We hypothesized that these phenotypes may be constituted by associated comorbidities that might have a fundamental effect on pain severity and disability (clinically relevant). The purpose of this study was to classify a cohort of patients with knee/hip osteoarthritis according with their comorbidities in these three phenotypes. The resulting groups were compared on the following clinical factors: pain severity, number of pain sites and disability. Methods: This is a cohort study of patients with knee or hip osteoarthritis, who received or are candidates to receive a joint replacement. All patients in this cohort presented advanced OA at hip and/or knee joints with radiographic evidence of the disease. We interviewed 862 patients. Patients with other pathologies, rheumatoid arthritis, lupus, avascular necrosis or fractures were excluded (n¼135). On top of medical records, questionnaires included: Gender and age, joint(s) affected with pain. Weight and height were measured and body mass index (BMI) was calculated. Patients were asked about the difficulty of walking and climbing stairs and it was scored from 0-3 as follows: without difficulty (0), with some (1), great difficulty (2) or unable to do (3). Pain at each joint was determined by the patients using a numerical rating scale (NRS). Comorbidities were identified, classified, or converted to the ICD-10 codes. Logistic regression and Analysis of variance (ANOVA) with mean values (m) were used to verify the degree of association of the comorbidities grouped in three phenotypes

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