PATHOPHYSIOLOGY OF POSTTRAUMATIC ANKLE OSTEOARTHRITIS: A MULTICENTER PERSPECTIVE.

IF 0.5 4区 医学 Q4 ORTHOPEDICS Acta Ortopedica Brasileira Pub Date : 2024-07-22 eCollection Date: 2024-01-01 DOI:10.1590/1413-785220243203e282286
Alexandre Leme Godoy-Santos, Cesar de Cesar, Simone Santini, Mario Herrera-Pérez, Victor Valderrabano, Stefan Rammelt
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Abstract

Besides the acute injury and trauma-induced macroscopic alterations, the evolution to posttraumatic ankle osteoarthritis (PTOA) is a complex process progressing at the tissue and molecular level. Furthermore, changes in the molecular pathways affect chondrocyte viability. Treatment modalities for PTOA focal or confined disease include innovative techniques.

Objective: Our purpose is to increase medical awareness based on scientific evidence of pathophysiology, molecular biology, and treatment of post-traumatic ankle osteoarthritis.

Methods: To support the perspectives of the experts, evidence from the scientific literature respected the PRISMA guidelines and the PICOS search strategy was used. We included case-control, cohort, experimental studies and case reports, written in English.

Results: The authors were homogeneously exposed to 282 selected abstracts and 114 full articles directly related to post-traumatic osteoarthritis after malleolar fractures.

Conclusion: The pathophysiological factors involved in posttraumatic ankle osteoarthritis, such as biological, structural, mechanical, and molecular changes must be studied together, as the interaction between these factors determines the risk of progression of PTOA. Inhibition of a single catabolic molecule or cascade probably is not sufficient to alter the natural progression of the pathological process. Evidence level V, expert opinion.

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创伤后踝关节骨关节炎的病理生理学:多中心视角。
除了急性损伤和创伤引起的宏观改变外,创伤后踝关节骨关节炎(PTOA)的演变是一个在组织和分子水平上发展的复杂过程。此外,分子途径的变化也会影响软骨细胞的活力。PTOA病灶或局限性疾病的治疗方法包括创新技术:我们的目的是根据创伤后踝关节骨关节炎的病理生理学、分子生物学和治疗方面的科学证据提高医学意识:为了支持专家们的观点,我们采用了遵守 PRISMA 指南和 PICOS 搜索策略的科学文献证据。我们纳入了用英语撰写的病例对照、队列、实验研究和病例报告:结果:282 篇精选摘要和 114 篇全文与踝骨骨折后创伤性骨关节炎直接相关,作者对其进行了同质化研究:创伤后踝关节骨关节炎所涉及的病理生理学因素,如生物、结构、机械和分子变化,必须一并研究,因为这些因素之间的相互作用决定了创伤后踝关节骨关节炎恶化的风险。抑制单一分解代谢分子或级联反应可能不足以改变病理过程的自然进展。证据等级 V,专家意见。
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来源期刊
CiteScore
0.90
自引率
14.30%
发文量
67
审稿时长
25 weeks
期刊介绍: A Revista Acta Ortopédica Brasileira, órgão oficial do Departamento de Ortopedia e Traumatologia da Faculdade de Medicina da Universidade de São Paulo (DOT/FMUSP), é publicada bimestralmente em seis edições ao ano (jan/fev, mar/abr, maio/jun, jul/ago, set/out e nov/dez) com versão em inglês disponível nos principais indexadores nacionais e internacionais e instituições de ensino do Brasil. Sendo hoje reconhecidamente uma importante contribuição para os especialistas da área com sua seriedade e árduo trabalho para as indexações já conquistadas.
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