Posttraumatic Osteoarthritis: A First Estimate of Incidence, Prevalence, and Burden of Disease

Abstract

Although posttraumatic osteoarthritis (OA) is a common and important entity in orthopedic practice, no data presently exist regarding its prevalence or its relative burden of disease. A population-based estimate was formulated, based on one large institution's experience in terms of its fraction of patients with OA presenting to lower-extremity adult reconstructive clinics with OA of posttraumatic origin. The relative proportion of these patients undergoing total joint replacement provided a basis for extrapolating institutional experience with posttraumatic OA to a populationwide estimate because the numbers of lower-extremity total joint arthroplasty procedures performed were reliably tabulated both within the institution and populationwide. By this methodology, approximately 12% of the overall prevalence of symptomatic OA is attributable to posttraumatic OA of the hip, knee, or ankle. This corresponds to approximately 5.6 million individuals in the United States being affected by posttraumatic OA sufficiently severe to have caused them to present for care by an orthopedic lower-extremity adult reconstructive surgeon. Further, based on the relative prevalence of OA versus rheumatoid arthritis, and their relative impacts as assessed by the SF-36 (Short-Form 36) lower-extremity physical composite scores, about 85.5% of the societal costs of arthritis are attributable to OA. The corresponding aggregate financial burden specifically of posttraumatic OA is Dollars 3.06 billion annually, or approximately 0.15% of the total U.S. health care direct cost outlay.

Melanocortin peptides protect chondrocytes from mechanically induced cartilage injury

“…Blunt trauma to articular cartilage, resulting from accidents or sport injuries are associated with high levels of chondrocyte death and is associated with local inflammatory reactions, thereby representing a major risk factor for the development of post-traumatic OA, which despite constant improvement of surgical techniques, still accounts for ~12% of all cases of OA [72].…”

Is Total Ankle Arthroplasty A Cost-effective Alternative to Ankle Fusion?

“…Ankle arthritis has an incidence of 1984 per 100,000 patients [3], which is eight times less frequent than knee or hip arthritis in clinical practice [4]. The physical and mental impairments for patients with ankle arthritis are equivalent to that of hip arthritis and other severely disabling medical problems [10,21,23].…”

Absence of posttraumatic arthritis following intraarticular fracture in the MRL/MpJ mouse

“…Recent estimates suggest that posttraumatic arthritis is responsible for 12% of the 21 million cases of OA in the US, at a cost of ϳ$7 billion annually to the US economy (2). Posttraumatic arthritis also causes disability in young and middle-aged patients, unlike idiopathic OA (3)(4)(5)(6).…”