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

Abstract

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. © 2019