Meniscal injury |
Incidence of 0.3-0.7/
1000 inhabitants. |
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- Severity of the meniscal damage.
- Meniscectomy
- Female sex and age > 40 years
- Obesity
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- Increased risk from OR=3 mild to OR 7.9 (4.4-14) for severe meniscal damage.
- After 19 years risk of OA increased by 11%., 24% after four years and 71% after 20 years.
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Proximal Tibial Fractures (PTF) |
Incidence of 0.1-0.13 per 1000 inhabitants |
- Males younger than 50 years.
- Accidents and high-energy traumas.
- More severe fractures in patients older than 50 years.
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- Operative treatment:
- High age principally in treated fractures.
- In younger patients: bicondylar fractures.
- Osteoporosis and other comorbidities including a high BMI.
- Malalignment of the knee, deviation of the mechanical axis in varus, articular step-off and meniscus lesion
- The severity of the lesion: Fracture comminution and articular collapse.
- Female sex.
- It is higher during the first years than at long term.
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- PTOA is generally estimated to occur in 23% to 36% of cases following an intra-articular fracture.
- Between 21–75% of cases after operative treatment develop PTOA even when adequate reduction and stable fixation have been achieved.
- Severe OA leading to TKR develops in 2.2–7.5% of operatively treated patients after 2 to 5 years post-trauma. Compared with all populations, these patients are at a 3.5
- to 5.3-fold higher risk of end-stage PTOA requiring TKR.
- Radiological signs of OA were reported in 10% to 83% of studied cases.
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Patellar dislocation |
Between 0.058-0.070 per 1000 person-years. |
- Active young individuals practicing sports.
- Decreased depth, a flat or even convex trochlear surface.
- Females have a 33% higher risk of patellar instability and dislocation than males.
- Military personal.
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- Patellofemoral instability due to recurrent dislocation.
- Increases over time.
- osteochondral injury and trochlear dysplasia.
- Female sex and older age.
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- The risk of OA increases with the number of years after dislocation, from non-significant increase till 22% at t13 years, and it achieves 50% after 25 years of follow-up.
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Acetabular fractures |
Around 8.1/100,000 persons/year in Europe |
- High energy trauma and accidents in the young population and low energy trauma such as falling in the elderly.
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- Residual articular incongruity, quality of fracture reduction.
- Column fractures, posterior wall and type A1 fracture.
- Male sex.
- Age older than 40 years.
- Obesity
- Associated chondral or osseous lesions of the femoral head.
- Involvement of the posterior wall and incongruence of the acetabular roof.
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- OA appeared after five years of follow-up in between 13% to 57% of all cases.
- OA was present in approximately 36% of cases after open reduction and internal fixation.
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Femoral Fractures |
Femoral neck: 63.3 cases per 100,000 person-years for women and 27.7 cases per 100,000 person-years for men (90 percent of proximal femur fractures)
Intertrochanteric: 34 men and 63 women/ 100,000 person years. They represents 38%-50% of all hip fractures, respectively. |
- Patients with a higher falling risk.
- Higher incidence of stress fractures in military.
- Female sex
- older age
- osteopenia or osteoporosis.
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- OA risk seems higher in trochanteric fractures than in patients with cervical fractures.
- Femoral shaft malunions increase the risk of OA symptoms, pain and stiffness after long-term follow up (>20years).
- In young patients, use of a hemiarthroplasty after femoral fractures has been linked to OA at follow up.
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- PTOA in 0.5% of cases with minimally displaced femoral neck fracture treated with internal fixation.
- After femoral shaft fractures and malunion, 8% of cases had radiographic evidence of OA.
- PTOA in 31% of cases after a failed internal fixation for hip fracture with a minimum 2-year follow-up.
- Around 11% of all performed THA are sequelae or failed internal fixation after proximal femur fracture.
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Hip dislocations |
- Most are posterior dislocations (90%).
- Classified as simple or complex (when associated with fractures).
- Acetabular fracture is present in up to 70% of patients with traumatic hip dislocations.
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- More prevalent in males between 14 or 16 years to 40.
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- Delayed closed dislocation reduction (>six hours of the injury).
- The severity of the injury correlates with an increase in the development of PTOA.
- Associated with femoral head fracture increase the risk of OA.
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- PTOA is the most common sequelae.
- Might appear just two years after the initial injury, being more common after ten years.
- It might be present in up to 24% of cases.
- PTOA in between 16-30% of patients with posterior dislocation and 50% when associated with femoral head fracture.
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