Post-traumatic osteoarthritis of the ankle: A distinct clinical entity requiring new research approaches.
Post-traumatic osteoarthritis of the ankle: A distinct clinical entity requiring new research approaches.
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DOI：
10.1002/jor.23462
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发表时间：
2017-03
期刊：
影响因子：
--
通讯作者：
Fortier LA
中科院分区：
文献类型：
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作者：
Delco ML;Kennedy JG;Bonassar LJ;Fortier LA
由于磁共振成像等非侵入性成像方式的进步、关节镜手术技术的改进以及临床医生意识的提高，踝关节骨关节炎（OA）的诊断正在增加。与膝关节OA不同，原发性或年龄相关性踝关节OA很少见，大多数踝关节OA被归类为创伤后（PTOA）。踝关节创伤，更具体地说是踝关节扭伤，是最常见的运动损伤，并且没有有效的治疗方法可用于预防或减缓PTOA的进展。尽管踝关节创伤和OA的发病率很高，但踝关节相关OA的研究很少，大多数临床和基础研究与膝关节有关。关节之间存在根本差异，包括其结构和分子组成、对创伤的反应、对OA的易感性、疾病的临床表现和对治疗的反应。大量证据表明，膝关节的研究结果不应外推至踝关节，但目前可获得的踝关节特异性PTOA临床前模型很少。本文的目的是回顾踝关节OA研究的现状，强调踝关节和膝关节之间的重要差异，这可能会限制膝关节模型的研究结果适用于踝关节的程度。考虑新的踝关节特异性，临床相关的动物模型的发展进行了讨论。
The diagnosis of ankle osteoarthritis (OA) is increasing as a result of advancements in non-invasive imaging modalities such as magnetic resonance imaging, improved arthroscopic surgical technology and heightened awareness among clinicians. Unlike OA of the knee, primary or age-related ankle OA is rare, with the majority of ankle OA classified as post-traumatic (PTOA). Ankle trauma, more specifically ankle sprain, is the single most common athletic injury, and no effective therapies are available to prevent or slow progression of PTOA. Despite the high incidence of ankle trauma and OA, ankle-related OA research is sparse, with the majority of clinical and basic studies pertaining to the knee joint. Fundamental differences exist between joints including their structure and molecular composition, response to trauma, susceptibility to OA, clinical manifestations of disease, and response to treatment. Considerable evidence suggests that research findings from knee should not be extrapolated to the ankle, however few ankle-specific preclinical models of PTOA are currently available. The objective of this article is to review the current state of ankle OA investigation, highlighting important differences between the ankle and knee that may limit the extent to which research findings from knee models are applicable to the ankle joint. Considerations for the development of new ankle-specific, clinically relevant animal models are discussed.