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

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Technical Report,30 Sep 2017,29 Sep 2018

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University of Iowa Iowa United States

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The objective of this research is to develop new models for predicting the risk of post-traumatic osteoarthritis PTOA following intra-articular fracture IAF. We have analyzed pre- and post-treatment CT data from patients with combat-related IAFs to measure fracture severity and post-reduction contact stress exposure. Our partner at SAMMC finalized enrollment during this year. The imaging data for 70 subjects with collectively 112 fractures have been forwarded to us for analysis, and we have completed fracture severity analysis of 93 IAFs. This is in addition to fracture energies having now been computed for 226 civilian IAFs. In our most recent analyses, we found a strong positive correlation explaining 85 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 acetabular IAF demonstrated a clear exposure threshold above which cases predictably progress to PTOA. Using a 2 MPa-sgait cycle threshold to predict which cases progressed to OA yielded a sensitivity of 100 percent and a specificity of 83.3 percent. During the coming no cost extension year, we will be performing further analysis of fracture severity and contact stress to more definitively test these findings prior to reporting them in a series of journal articles.

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  • Medicine and Medical Research

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