Open Access Journal of Sports Medicine Dovepress Post-traumatic Knee Osteoarthritis in the Young Patient: Therapeutic Dilemmas and Emerging Technologies

Traumatic knee injury is common in young adults and strongly contributes to premature development of knee osteoarthritis (OA). Post-traumatic knee OA poses a therapeutic dilemma to the physician, since no known therapy has an acceptable safety profile, effectively relieves joint pain, and enjoys reasonable patient acceptance. Consequently, these young patients will ultimately be faced with the decision to either undergo surgical intervention, despite prosthesis durability concerns, or to continue with ineffective nonsurgical treatment. Emerging therapies, such as biologics, disease-modifying drugs, partial joint resurfacings, and minimally invasive joint-unloading implants are currently being studied to fill this therapeutic void in the young patient with post-traumatic knee OA.

[1]  M. Lotz New developments in osteoarthritis. Posttraumatic osteoarthritis: pathogenesis and pharmacological treatment options , 2010, Arthritis research & therapy.

[2]  James A. Martin,et al.  Post‐traumatic osteoarthritis: Improved understanding and opportunities for early intervention , 2011, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[3]  Thomas P Andriacchi,et al.  Rotational Changes at the Knee after ACL Injury Cause Cartilage Thinning , 2006, Clinical orthopaedics and related research.

[4]  B. Fregly,et al.  Correlation between the knee adduction torque and medial contact force for a variety of gait patterns , 2007, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[5]  L. Good,et al.  Postural control — a comparison between patients with chronic anterior cruciate ligament insufficiency and healthy individuals , 1998, Scandinavian journal of medicine & science in sports.

[6]  G. Jay,et al.  Comparison of differential biomarkers of osteoarthritis with and without posttraumatic injury in the Hartley guinea pig model , 2010, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[7]  James G Wright,et al.  Determining the Need for Hip and Knee Arthroplasty: The Role of Clinical Severity and Patients’ Preferences , 2001, Medical care.

[8]  M. Barbe,et al.  Joint trauma initiates knee osteoarthritis through biochemical and biomechanical processes and interactions , 2013 .

[9]  L. Miller,et al.  Midterm Outcomes and Predictors of Clinical Success With the KineSpring Knee Implant System , 2013, Clinical medicine insights. Arthritis and musculoskeletal disorders.

[10]  A. Grodzinsky,et al.  Mechanical injury of cartilage explants causes specific time-dependent changes in chondrocyte gene expression. , 2005, Arthritis and rheumatism.

[11]  A. Amendola Unicompartmental osteoarthritis in the active patient: the role of high tibial osteotomy. , 2003, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[12]  J A Buckwalter,et al.  Osteoarthritis and articular cartilage use, disuse, and abuse: experimental studies. , 1995, The Journal of rheumatology. Supplement.

[13]  M. Hochberg,et al.  Joint Injury in Young Adults and Risk for Subsequent Knee and Hip Osteoarthritis , 2000, Annals of Internal Medicine.

[14]  C. Haasper,et al.  Failed joint unloading implant system in the treatment of medial knee osteoarthritis , 2013, Archives of Orthopaedic and Trauma Surgery.

[15]  J. Block,et al.  Unload it: the key to the treatment of knee osteoarthritis , 2011, Knee Surgery, Sports Traumatology, Arthroscopy.

[16]  B. Morrey Prevalence of Primary and Revision Total Hip and Knee Arthroplasty in the United States From 1990 Through 2002Kurtz S, Mowat F, Ong K, et al (Exponent Inc, Philadelphia) J Bone Joint Surg Am 87-A:1487–1497, 2005§ , 2006 .

[17]  T. Andriacchi,et al.  Gait mechanics influence healthy cartilage morphology and osteoarthritis of the knee. , 2009, The Journal of bone and joint surgery. American volume.

[18]  E. Roos,et al.  The Long-term Consequence of Anterior Cruciate Ligament and Meniscus Injuries , 2007, The American journal of sports medicine.

[19]  B. Fleming,et al.  Ligament Injury, Reconstruction and Osteoarthritis. , 2005, Current opinion in orthopaedics.

[20]  L. Miller,et al.  Knee Osteoarthritis Treatment with the KineSpring Knee Implant System: A Report of Two Cases , 2012, Case reports in orthopedics.

[21]  S. Gabriel,et al.  Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. , 2008, Arthritis and rheumatism.

[22]  E. Roos,et al.  Knee osteoarthritis after meniscectomy: prevalence of radiographic changes after twenty-one years, compared with matched controls. , 1998, Arthritis and rheumatism.

[23]  Thomas P Andriacchi,et al.  Knee kinematics, cartilage morphology, and osteoarthritis after ACL injury. , 2008, Medicine and science in sports and exercise.

[24]  L. Huston,et al.  Longitudinal Effects of Anterior Cruciate Ligament Injury and Patellar Tendon Autograft Reconstruction on Neuromuscular Performance , 2000, The American journal of sports medicine.

[25]  M. Bhandari,et al.  Cost-effectiveness and economic impact of the KineSpring® Knee Implant System in the treatment for knee osteoarthritis , 2013, Knee Surgery, Sports Traumatology, Arthroscopy.

[26]  L. Miller,et al.  Conservative management of symptomatic knee osteoarthritis: a flawed strategy? , 2013, Orthopedic reviews.

[27]  E. Roos,et al.  Impact of type of meniscal tear on radiographic and symptomatic knee osteoarthritis: a sixteen-year followup of meniscectomy with matched controls. , 2003, Arthritis and rheumatism.

[28]  J P Corrigan,et al.  Proprioception in the cruciate deficient knee. , 1992, The Journal of bone and joint surgery. British volume.

[29]  K. Markolf,et al.  The role of the meniscus in the anterior-posterior stability of the loaded anterior cruciate-deficient knee. Effects of partial versus total excision. , 1986, The Journal of bone and joint surgery. American volume.

[30]  M. Hellio Le Graverand-Gastineau,et al.  OA clinical trials: current targets and trials for OA. Choosing molecular targets: what have we learned and where we are headed? , 2009, Osteoarthritis and cartilage.

[31]  Alan J Grodzinsky,et al.  Mechanisms and kinetics of glycosaminoglycan release following in vitro cartilage injury. , 2004, Arthritis and rheumatism.

[32]  Atlanta,et al.  Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part I. , 2008, Arthritis and rheumatism.

[33]  J. Ranstam,et al.  Treatment for acute anterior cruciate ligament tear: five year outcome of randomised trial , 2013, BMJ.

[34]  E. Roos,et al.  Joint injury causes knee osteoarthritis in young adults , 2005, Current opinion in rheumatology.

[35]  H. Roos,et al.  Knee ligament injury, surgery and osteoarthrosis. Truth or consequences? , 1994, Acta orthopaedica Scandinavica.

[36]  J. Buckwalter Articular cartilage: injuries and potential for healing. , 1998, The Journal of orthopaedic and sports physical therapy.

[37]  Paul Tornetta,et al.  Unloading the osteoarthritic knee with a novel implant system. , 2013, Journal of applied biomechanics.

[38]  G. Dowd,et al.  High tibial osteotomy for medial compartment osteoarthritis. , 2006, The Knee.

[39]  T. Bauer,et al.  Evaluation of the safety of a novel knee load-bypassing device in a sheep model. , 2012, The Journal of bone and joint surgery. American volume.

[40]  E. Roos,et al.  High prevalence of osteoarthritis 14 years after an anterior cruciate ligament tear in male soccer players: a study of radiographic and patient relevant outcomes , 2004, Annals of the rheumatic diseases.

[41]  P. Smolinski,et al.  Progressive Chondrocyte Death After Impact Injury Indicates a Need for Chondroprotective Therapy , 2009, The American journal of sports medicine.

[42]  P Tugwell,et al.  OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. , 2008, Osteoarthritis and cartilage.

[43]  A. Thambyah A hypothesis matrix for studying biomechanical factors associated with the initiation and progression of posttraumatic osteoarthritis. , 2005, Medical hypotheses.

[44]  M. Englund,et al.  Risk factors for symptomatic knee osteoarthritis fifteen to twenty-two years after meniscectomy. , 2004, Arthritis and rheumatism.

[45]  A Clifford,et al.  The KineSpring load absorber implant: rationale, design and biomechanical characterization , 2011, Journal of medical engineering & technology.

[46]  P. Lechler,et al.  [The 2-year follow-up results of a patient-specific interpositional knee implant]. , 2011, Der Orthopade.

[47]  M. Reijman,et al.  Ten year follow-up study comparing conservative versus operative treatment of anterior cruciate ligament ruptures. A matched-pair analysis of high level athletes , 2008, British Journal of Sports Medicine.

[48]  J. Rao,et al.  Traumatic dislocation and fracture dislocation of the hip. A long-term follow-up study. , 1987, Clinical orthopaedics and related research.

[49]  Eva Ageberg,et al.  Consequences of a ligament injury on neuromuscular function and relevance to rehabilitation - using the anterior cruciate ligament-injured knee as model. , 2002, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[50]  L. Miller,et al.  The KineSpring® Knee Implant System: an implantable joint-unloading prosthesis for treatment of medial knee osteoarthritis , 2013, Medical devices.

[51]  P. Ohtonen,et al.  Incidence of osteotomies around the knee for the treatment of knee osteoarthritis: A 22-year population-based study , 2012, International Orthopaedics.

[52]  S. Roy,et al.  The Unispacer knee implant: early clinical results. , 2008, The Journal of bone and joint surgery. British volume.

[53]  Thomas D Brown,et al.  Posttraumatic Osteoarthritis: A First Estimate of Incidence, Prevalence, and Burden of Disease , 2006, Journal of orthopaedic trauma.

[54]  R. Aspden,et al.  Osteoarthritis: a problem of growth not decay? , 2008, Rheumatology.

[55]  Steven Kurtz,et al.  Prevalence of primary and revision total hip and knee arthroplasty in the United States from 1990 through 2002. , 2005, The Journal of bone and joint surgery. American volume.

[56]  S M Lephart,et al.  The Effects of Joint Position and Direction of Joint Motion on Proprioceptive Sensibility in Anterior Cruciate Ligament-Deficient Athletes , 1997, The American journal of sports medicine.

[57]  J. Lonner,et al.  Total Knee Arthroplasty in Patients 40 Years of Age and Younger With Osteoarthritis , 2000, Clinical orthopaedics and related research.

[58]  M. Englund,et al.  High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior cruciate ligament injury. , 2004, Arthritis and rheumatism.

[59]  L. Miller,et al.  Successful two-stage revision of a KineSpring® joint unloading implant: a case study , 2012, International medical case reports journal.

[60]  M. Lotz,et al.  Posttraumatic osteoarthritis: pathogenesis and pharmacological treatment options , 2010 .

[61]  Freddie H. Fu,et al.  Importance of the medial meniscus in the anterior cruciate ligament‐deficient knee , 2000, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[62]  Kenneth D Brandt,et al.  Etiopathogenesis of osteoarthritis. , 2009, The Medical clinics of North America.

[63]  K. Kalunian,et al.  New developments in osteoarthritis. , 2007, Rheumatic diseases clinics of North America.

[64]  B. Fell,et al.  Unicompartmental Tibial Hemiarthroplasty Early Results of the UniSpacer™ Knee , 2003, Clinical orthopaedics and related research.

[65]  David R Wilson,et al.  The measurement of joint mechanics and their role in osteoarthritis genesis and progression. , 2013, Rheumatic diseases clinics of North America.

[66]  G. Hofmann,et al.  The impact of a high tibial valgus osteotomy and unicondylar medial arthroplasty on the treatment for knee osteoarthritis: a meta-analysis , 2011, Knee Surgery, Sports Traumatology, Arthroscopy.

[67]  D. Sisto,et al.  UniSpacer arthroplasty of the knee. , 2005, The Journal of bone and joint surgery. American volume.

[68]  L. Lidgren,et al.  Unicompartmental knee arthroplasty in patients aged less than 65 , 2010, Acta orthopaedica.

[69]  L. Salmon,et al.  Long-Term Survival of High Tibial Osteotomy for Medial Compartment Osteoarthritis of the Knee , 2011, The American journal of sports medicine.

[70]  Jinxi Wang,et al.  Pathogenetic mechanisms of posttraumatic osteoarthritis: opportunities for early intervention. , 2011, International journal of clinical and experimental medicine.

[71]  H. Schmitt,et al.  The UniSpacer™: correcting varus malalignment in medial gonarthrosis , 2010, International Orthopaedics.

[72]  Gillian A Hawker,et al.  A prospective population-based study of the predictors of undergoing total joint arthroplasty. , 2006, Arthritis and rheumatism.

[73]  J. Jordan,et al.  Lifetime Risk and Age at Diagnosis of Symptomatic Knee Osteoarthritis in the US , 2013, Arthritis care & research.

[74]  D J Beard,et al.  Proprioception after rupture of the anterior cruciate ligament. An objective indication of the need for surgery? , 1993, The Journal of bone and joint surgery. British volume.

[75]  James G Wright,et al.  Perceptions of, and willingness to consider, total joint arthroplasty in a population-based cohort of individuals with disabling hip and knee arthritis. , 2004, Arthritis and rheumatism.

[76]  E. Radin,et al.  Hypothesis: joints can heal. , 1984, Seminars in arthritis and rheumatism.

[77]  E. Baulot,et al.  The Unispacer™ unicompartmental knee implant: its outcomes in medial compartment knee osteoarthritis. , 2011, Orthopaedics & traumatology, surgery & research : OTSR.

[78]  J. Buckwalter,et al.  Athletics and Osteoarthritis , 1997, The American journal of sports medicine.

[79]  D. Atlıhan,et al.  Traumatic dislocation and fracture-dislocation of the hip: a long-term follow-up study. , 2003, The Journal of trauma.

[80]  H. Aro,et al.  High tibial osteotomy for the treatment of osteoarthritis of the knee: a review of the literature and a meta-analysis of follow-up studies , 2004, Archives of Orthopaedic and Trauma Surgery.