Centre for Osteoarthritis Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
Curr Opin Rheumatol. 2021 Jan;33(1):74-83. doi: 10.1097/BOR.0000000000000760.
Current thinking in the study of posttraumatic osteoarthritis (PTOA) is overviewed: the osteoarthritis which follows acute joint injury. The review particularly highlights important publications in the last 18 months, also reflecting on key older literature, in terms of what have we have we learned and have yet to learn from PTOA, which can advance the osteoarthritis field as a whole.
PTOA is a mechanically driven disease, giving insight into mechanical drivers for osteoarthritis. A mechanosensitive molecular tissue injury response (which includes activation of pain, degradative and also repair pathways) is triggered by acute joint injury and seen in osteoarthritis. Imaging features of PTOA are highly similar to osteoarthritis, arguing against it being a different phenotype. The inflammatory pathways activated by injury contribute to early joint symptoms. However, later structural changes appear to be dissociated from traditional measures of synovial inflammation.
PTOA remains an important niche in which to understand processes underlying osteoarthritis and seek interventional targets. Whether PTOA has true molecular or clinical differences to osteoarthritis as a whole remains to be understood. This knowledge is important for a field where animal modelling of the disease relies heavily on the link between injury and osteoarthritis.
概述创伤后骨关节炎（PTOA）的研究现状：即继发于急性关节损伤的骨关节炎。本文特别强调了过去 18 个月内的重要出版物，并就我们从 PTOA 中学到了什么以及尚未了解到什么进行了思考，以期为整个骨关节炎领域提供新的见解。
PTOA 是一种机械驱动疾病，深入了解了骨关节炎的机械驱动因素。急性关节损伤会引发一种机械敏感的分子组织损伤反应（包括疼痛、降解和修复途径的激活），这在骨关节炎中可见。PTOA 的影像学特征与骨关节炎高度相似，这表明其并非一种不同的表型。损伤激活的炎症途径会导致早期关节症状。然而，后期的结构变化似乎与滑膜炎症的传统测量指标无关。
PTOA 仍然是一个重要的研究领域，有助于理解骨关节炎的潜在发病机制并寻找干预靶点。PTOA 是否与整体骨关节炎存在真正的分子或临床差异仍有待了解。这一认识对于该领域非常重要，因为疾病的动物模型研究严重依赖于损伤与骨关节炎之间的联系。
