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This article, Post-traumatic arthritis, has recently been created via the Articles for creation process. Please check to see if the reviewer has accidentally left this template after accepting the draft and take appropriate action as necessary.
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  • Comment: The topic is notable enough for an article, but your references are really too weak to use to write a medical article. Please read through WP:MEDRS for guidance on the sort of sources needed. Take a look at the sources used in Osteoarthritis and see if any of them have information relevant to post-traumatic arthritis. If you improve your sources, the article will be ready to be moved into article space, but will still need work. Please let me know once you have added some good quality reviews that are indexed in PubMed. In fact it's worth searching https://www.ncbi.nlm.nih.gov/pubmed/?term=post-traumatic+arthritis - you'll get over 1,200 hits, so there's a lot of sifting to do.If you wish to improve the whole article before publishing, please look at WP:MEDSECTIONS and try to add at least a diagnosis section. Feel free to post at WT:WikiProject Medicine for more advice as you need it. RexxS (talk) 22:25, 27 March 2018 (UTC)

Post-traumatic arthritis (PTA) is a form of osteoarthritis subsequent to an acute trauma to the joints. In most cases, post-traumatic arthritis follows a physical injury, such as a sprained knee, which happened before the post-traumatic arthritis diagnosis.

Classification

Post-traumatic arthritis is counted to osteoarthritis, whereby it occurs way later after the osteoarthritis. However, post-traumatic arthritis can occur also after a chronic inflammatory arthritis.

Generally post-traumatic arthritis is classified in two groups:

Post-traumatic osteoarthritis

Post-traumatic osteoarthritis is the most common variation of post-traumatic arthritis. Between 20 % and 50 % of all osteoarthritis cases are followed by post-traumatic arthritis. Patients having post-traumatic osteoarthritis are usually younger than osteoarthritis patients without any previous physical injuries.

Post-traumatic inflammatory arthritis

Less common are post-traumatic inflammatory arthritis, accounting between 2 % and 25 % of all post-traumatic arthritis cases. There are reports about a connection between previous physical injury and inflammatory arthritis, such as rheumatoid arthritis or psoriatic arthritis.

Signs and symptoms

The symptoms of post-traumatic arthritis are similiar to the ones occuring with osteoarthritis. General symptoms are stiffness, swelling, synovial effusion, pain, redness, tenderness, grinding, instability and intra-articular bleeding of the injured joint.

As a result of this symptoms, post-traumatic arthritis often comes along with the loss of ability.

Risk factors

Since post-traumatic arthritis usually occurs after a physical injury of a joint, the risk of having post-traumatic arthritis after such a injury is significant higher. Risk factors which increase the danger of getting post-traumatic arthritis are being overweight and physical activity. The prevalance of post-traumatic arthritis is much higher when doing heavy work and overusing the injured joints. Examinations also revealed that a body mass index (BMI) increase of five unites results in a 35 % higher risk of post-traumatic arthritis.

It is reported that genetics do have an influence on the prevelance of post-traumatic arthritis. According to newer examinations, the sex of the patients may also has influence on post-traumatic arthritis since there are way more women affected by post-traumatic arthritis than men .

Pathogenesis and etiology

The process of post-traumatic arthritis can basically be divided in three sections:

Immediate phase

This phase usually begins just a few seconds after the trauma happend; it is characterized by cell necrosis, collagen rapture, cartilage swelling, hermathrosis and GAG loss.

Acute phase

In this phase the acute post-traumatic arthrosis emerge. Matrix degradation, leukocyte infiltration, inflammatory mediators, deficient lubricants and apoptosis can occur. Typically the acute phase comes hours after the injury.

Chronic phase

The chronic phase occurs months or years after the trauma. Typical symptoms are joint pain and dysfunction.

Diagnosis

The diagnosis is made via anamnesis with the aid of the patient history. Additionally post-traumatic arthritis can be diagnosed with technical tools such as X-ray.

Management and prevention

It is not possible to cure the acute post-traumatic arthritis in order to prevent a chronic post-traumatic arthritis. Therefore there are many different options to manage chronic post-traumatic arthritis, thus it cannot be cured at the moment.

Life style

Since being overweight is a risk factor for post-traumatic arthritis, it is a major point of the treatment and prevention of post-traumatic arthritis to control the individual body weight and to reduce it if needed. Life style changes and weight loss often involves to educate the affected person in terms of a healthy life style.

Therapeutic measures

To reduce pain and other symptoms of post-traumatic arthitis, it can be made use of physical therapy. The use of massage therapy and manual therapy therefore could not be proven yet.

Medication

Post-traumatic arthritis is treaten symptomatically with non-steroidal anti-inflammantory drugs (NSAIDs). For more moderate symptomes there is also acetaminophen (Paracetamol) used. Another medical treatment approach is the injection of cortisone or corticosteriod into the affected joint.

Surgery

If medication, changes in the patient's life style and physical measure were not effective enough to reduce the symptoms and especially the pain, there is the opportunity to use surgical and interventional methods for managing post-traumatic arthritis. In many cases it is recommended to do a joint replacement surgery or resurfacing the cartilage. As clinical studies demonstrated, such surgical methods can be seen as effective in terms of pain reduction and costs.

Epidemology

About 12 % of all osteoarthritis cases in the United States are classified as post-traumatic osteoarthritis. This means that over 5.6 million people are affected by post-traumatic osteoarthritis only in the US. Women are more often affected than men.

Post-traumatic arthritis costs the US health system about US$ 3.06 billion or 0.15 % of the health care budget a year.

References

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