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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2021; 56(06): 689-696
DOI: 10.1055/s-0040-1709733
Artigo de Atualização
Pé e Tornozelo

Ankle Osteoarthritis[∗]

Article in several languages: português | English
Alexandre Leme Godoy-Santos 
1   Laboratório Prof Manlio Mario Marco Napoli, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
2   Programa Aparelho Locomotor, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil
,
Lucas Furtado Fonseca 
3   Departamento de Ortopedia, Universidade Federal de São Paulo, São Paulo, SP, Brasil
,
Cesar de Cesar Netto 
4   Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA, United States
,
Vincenzo Giordano 
5   Serviço de Ortopedia e Traumatologia Prof Nova Monteiro, Hospital Municipal Miguel Couto, Rio de Janeiro, SP, Brasil
,
Victor Valderrabano 
6   Swiss Ortho Center, University of Basel, Schmerzklinik Basel, Basel, Suíça
,
Stefan Rammelt 
7   Universitäts Centrum für Orthopädie und Unfallchirurgie, Universitätsklinikum Carl Gustav Carus, Dresden, Alemanha
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Abstract

Osteoarthritis (OA) is characterized by a chronic, progressive and irreversible degradation of the joint surface associated with joint inflammation. The main etiology of ankle OA is post-traumatic and its prevalence is higher among young and obese people. Despite advances in the treatment of fractures around the ankle, the overall risk of developing post-traumatic ankle OA after 20 years is almost 40%, especially in Weber type B and C bimalleolar fractures and in fractures involving the posterior tibial border. In talus fractures, this prevalence approaches 100%, depending on the severity of the lesion and the time of follow-up. In this context, the current understanding of the molecular signaling pathways involved in senescence and chondrocyte apoptosis is fundamental. The treatment of ankle OA is staged and guided by the classification systems and local and patient conditions. The main problems are the limited ability to regenerate articular cartilage, low blood supply, and a shortage of progenitor stem cells.

The present update summarizes recent scientific evidence of post-traumatic ankle OA with a major focus on changes of the synovia, cartilage and synovial fluid; as well as the epidemiology, pathophysiology, clinical implications, treatment options and potential targets for therapeutic agents.

Keywords

osteoarthritis - ankle - cartilage - synovial fluid - therapeutics

∗ Study performed at the Institute of Orthopedics and Traumatology of the Faculty of Medicine of the Universidade de São Paulo, São Paulo, SP, Brazil.




Publication History

Received: 14 July 2019

Accepted: 10 January 2020

Article published online:
29 May 2020

© 2020. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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