Post-traumatic osteoarthritis
| Classification according to ICD-10 | |
|---|---|
| M19.1- | Post-traumatic osteoarthritis The fourth digit indicates the location of the musculoskeletal involvement: 0 multiple locations 1 shoulder region 2 upper arm 3 forearm 4 hand 5 pelvic region and thigh 6 lower leg 7 ankle and foot 8 other 9 unspecified locations |
| ICD-10 online (WHO version 2019) | |
Injuries to the bones or the ligamentous apparatus can generally lead to joint damage, which in the later course leads to injury-related, post-traumatic osteoarthritis .
causes
Fractures without joint involvement
Breaks z. B. the shaft of a tubular bone and later heals in a less than ideal position, this can result in an axial misalignment of neighboring joints. Any coarser misalignment caused arbitrarily leads to a load on at least one joint that is not adapted to the body and also does not correspond to the normal shape; that then wears out - e.g. Sometimes much - faster than usual and soon very painful to osteoarthritis .
Fractures with joint involvement
If a trauma (as a fracture) goes through a joint surface, such an injury often heals, despite all efforts, with a step formation in the joint. This means that an early cartilage damage is preprogrammed: If the cartilage is worn out, the joint-bone itself then wears out; osteoarthritis develops very quickly as a result of the trauma, which is soon very painful and much faster than normal. Unprotected, bone then rubs against bone until the joint bone itself is completely used up somewhere. In the final stage, a kind of " pitting corrosion " forms an ever-growing hole on the bare joint surface, which fills with fluid.
Debris cysts or rubble cysts are called - synonymously - such osteoarthritis due to severe damage to the joint bone up to the medullary canal, the first name suggesting a traumatic cause, while the latter also stands for normally caused joint wear.
Torn ligaments
Ligament injuries often result in poor guidance in the joint capsular ligament apparatus. Under load, the joint surfaces can tilt against each other, the cartilage layer is overloaded, wear and tear leads to osteoarthritis .
therapy
If post-traumatic osteoarthritis has occurred, the natural axes of the joint can be restored using a conversion osteotomy , if the individual case requires it . Smoothing interventions on the articular cartilage often only lead to a short-term improvement in the symptoms.
In order to restore an unstable ligamentous apparatus, there are various plastic interventions, where, for example, tendons are removed from another part of the body and sutured instead of the damaged ligament. On traumatic cartilage damage in joints, cf. generally under osteoarthritis or especially - if caused by an accident - under a debris cyst .
