Post-Traumatic Osteoarthritis: Biologic Approaches to Treatment

摘要: Joint injuries are becoming increasingly common, with young adults between the ages of 1844 seeking medical attention for joint sprains, dislocation, fractures, anterior cruciate ligament (ACL) and meniscal tears, others. The cascade events that follow these have been shown to increase risk post-traumatic osteoarthritis (PTOA) by 2050% (Anderson et al,2011). Therefore, understanding biological responses predispose PTOA should help in determining treatment strategies delay and/or prevent progression disease. Ex vivo studies al,2011;Buckwalter al,2004;Furman al, 2007; Guilak al,2004; Hurtig 2009) provided evidence force severity impact applied among factors involved development PTOA. Recent research on trauma chondrocyte death apoptosis, inflammation (elevation caspases, selected proinflammatory cytokines, matrix fragments, nitric oxide, reactive oxygen species [ROS], etc.) damage/fragmentation be early phase injury. Together they lead OA-like focal cartilage lesions characterized loss constituents, surface fibrillation, fissures if untreated a tendency expand progress fully-blown Currently, only treatments available surgical interventions, such as microfracture, articular transplantation, autografting, allografting, debridement lavage. There also some experimental approaches involve engineering use juvenile cartilage, scaffolds various polymeric matrices, but those still development. To best our knowledge none them could regenerate normal adult hyaline is able perform required functions, sustain load integrate host tissue. Furthermore, newly repaired tissue, due its imperfect structural organization, may more susceptible re-injury, an important aspect often remains forgotten. there unmet need novel therapeutic based mechanisms drive onset order stimulate biologic repair, or surgery, when used together, improve outcome interventions biologics prior, during, soon after surgery. Based current molecular