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Pathomechanics of Post-Traumatic OA Development in the Military Following Articular Fracture

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Technical Report,30 Sep 2015,29 Sep 2019

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University of Iowa Iowa City United States

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The objective of this research was to develop new models for predicting the risk of post-traumatic osteoarthritis PTOA following intra-articular fracture IAF. New methods were developed to expedite the computation of acute fracture severity and chronic contact stress elevation after IAF. Using these new methods, pre- and post-treatment CT data from patients with IAFs were analyzed to measure fracture severity and post-reduction contact stress exposure. Imaging data for 70 subjects with collectively 112 fractures were received, and we completed fracture severity analysis of 82IAFs. This is in addition to fracture energies having now been computed for 394 civilian IAFs. We found a strong positive correlation explaining 97 percent of the variance between fracture energy per unit contact area and PTOA rates across 5 different joints, without controlling for any operative factors, whatsoever. Analyses of contact stress elevation after IAF of the distal tibial pilon, acetabulum, or calcaneus also demonstrated an exposure threshold above which cases predictably progress to PTOA. The best combined predictive models had excellent agreement with PTOA outcome after IAF of the distal tibial pilon 100 percent, acetabulum 91 percent, or calcaneus 88 percent.

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  • Medicine and Medical Research

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