Changes in cartilage, synovial cells and synovial fluid after malleolar fractures: What its importance for post-traumatic ankle osteoarthitis?

Background: Despite advances in malleolar fractures treatment, the overall risk to develop posttraumatic ankle osteoarthritis after 20 years is almost 40%, especially bimalleolar Weber type B and C fractures and fractures involving the posterior tibial rim. Methods: We performed a systematic literature review of clinical studies targeting the changes in cartilage, synovial cells and synovial fluid after malleolar fractures. Results: The acute ankle injury initiates a sequence of biological events potentially leading to progressive articular surface damage resulting from inflammatory changes in cartilage, synovial tissue and synovial fluid. Conclusion: A better understanding of the molecular and histological changes induced by acute trauma may potentially lead to novel, targeted treatment of malleolar fractures besides anatomical reduction and adequate stabilization.

Duke Scholars

Author Cesar de Cesar Netto Orthopaedic Surgery