Fractures involving the articular surface or that cause joint instability can lead to secondary osteoarthritis (OA) over time. While malunion of long bone fractures may increase risk of OA in adjacent joints through segmental overload, research shows that tibial fractures with moderate angular deformities up to 15 degrees do not carry an increased risk, especially for mid-shaft fractures away from joints. The signs of OA in x-rays include narrowing of the joint space, subchondral sclerosis, marginal osteophytes, subchondral cysts, and bone remodeling. Surgery for OA is considered for progressive joint destruction causing severe pain, instability and deformity, especially of weight-bearing joints.
Fractures involving the articular surface or that cause joint instability can lead to secondary osteoarthritis (OA) over time. While malunion of long bone fractures may increase risk of OA in adjacent joints through segmental overload, research shows that tibial fractures with moderate angular deformities up to 15 degrees do not carry an increased risk, especially for mid-shaft fractures away from joints. The signs of OA in x-rays include narrowing of the joint space, subchondral sclerosis, marginal osteophytes, subchondral cysts, and bone remodeling. Surgery for OA is considered for progressive joint destruction causing severe pain, instability and deformity, especially of weight-bearing joints.
Fractures involving the articular surface or that cause joint instability can lead to secondary osteoarthritis (OA) over time. While malunion of long bone fractures may increase risk of OA in adjacent joints through segmental overload, research shows that tibial fractures with moderate angular deformities up to 15 degrees do not carry an increased risk, especially for mid-shaft fractures away from joints. The signs of OA in x-rays include narrowing of the joint space, subchondral sclerosis, marginal osteophytes, subchondral cysts, and bone remodeling. Surgery for OA is considered for progressive joint destruction causing severe pain, instability and deformity, especially of weight-bearing joints.
Fractures involving the articular surface are obvious precursors of
secondary OA, so too lesser injuries which result in joint instability. What is less certain is whether malunion of a long-bone fracture predisposes to OA by causing segmental overload in a joint above or below the healed fracture (for example, in the knee or ankle after a tibial fracture). Contrary to popular belief, research has shown that moderate angular deformities of the tibia (up to 15 degrees) are not associated with an increased risk of OA (Merchant and Dietz, 1989). This applies to mid- shaft fractures; malunion close to a joint may well predispose to secondary OA.
Tanda OA pada X-Ray
1. Narrowing of the joint space
2. Subchondral sclerosis
3. Marginal osteophytes
4. Subchondral cysts
5. Bones remodelling
Indikasi Operasi pada OA
Progressive joint destruction, with increasing pain, instability and deformity (particularly of one of the weightbearing joints