title: Post-traumatic knee osteoarthritis in the young patient: therapeutic dilemmas and emerging technologies.
abstract: Traumatic knee injury is common in young adults and strongly contributes to premature development of knee osteoarthritis (OA). Post-traumatic knee OA poses a therapeutic dilemma to the physician, since no known therapy has an acceptable safety profile, effectively relieves joint pain, and enjoys reasonable patient acceptance. Consequently, these young patients will ultimately be faced with the decision to either undergo surgical intervention, despite prosthesis durability concerns, or to continue with ineffective nonsurgical treatment. Emerging therapies, such as biologics, disease-modifying drugs, partial joint resurfacings, and minimally invasive joint-unloading implants are currently being studied to fill this therapeutic void in the young patient with post-traumatic knee OA.
authors.affiliation: Palm Beach Sports Medicine, West Palm Beach, FL, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Stiebel
authors.affiliation: Miller Scientific Consulting, Inc, Asheville, NC, USA ; The Jon Block Group, San Francisco, CA, USA.
authors.forename: Larry E
authors.initials: LE
authors.lastname: Miller
authors.affiliation: The Jon Block Group, San Francisco, CA, USA.
authors.forename: Jon E
authors.initials: JE
authors.lastname: Block
keywords: KineSpring; implant; injury; joint unloading; knee; minimally invasive; osteoarthritis; post-traumatic
references.citation: Osteoarthritis Cartilage. 2008 Feb;16(2):137-62
references.pmid: 18279766
references.citation: Int Med Case Rep J. 2012 Dec 12;5:91-5
references.pmid: 23754932
references.citation: J Trauma. 2003 Mar;54(3):520-9
references.pmid: 12634533
references.citation: J Rheumatol Suppl. 1995 Feb;43:13-5
references.pmid: 7752117
references.citation: Semin Arthritis Rheum. 1984 Feb;13(3):293-302
references.pmid: 6729484
references.citation: Int Orthop. 2010 Dec;34(8):1175-9
references.pmid: 19946773
references.citation: Knee Surg Sports Traumatol Arthrosc. 2011 Nov;19(11):1823-9
references.pmid: 21298256
references.citation: Arthritis Rheum. 2008 Jan;58(1):26-35
references.pmid: 18163497
references.citation: J Bone Joint Surg Br. 2008 Apr;90(4):446-50
references.pmid: 18378917
references.citation: J Med Eng Technol. 2011 Jan;35(1):65-71
references.pmid: 21142591
references.citation: Med Clin North Am. 2009 Jan;93(1):1-24, xv
references.pmid: 19059018
references.citation: Arthroscopy. 2003 Dec;19 Suppl 1:109-16
references.pmid: 14673428
references.citation: J Bone Joint Surg Br. 1993 Mar;75(2):311-5
references.pmid: 8444956
references.citation: J Orthop Trauma. 2006 Nov-Dec;20(10):739-44
references.pmid: 17106388
references.citation: Clin Orthop Relat Res. 2009 Oct;467(10):2606-12
references.pmid: 19360453
references.citation: J Orthop Sports Phys Ther. 1998 Oct;28(4):192-202
references.pmid: 9785255
references.citation: Am J Sports Med. 2000 May-Jun;28(3):336-44
references.pmid: 10843124
references.citation: Arthritis Rheum. 2004 Oct;50(10):3145-52
references.pmid: 15476248
references.citation: J Orthop Res. 2007 Jun;25(6):789-97
references.pmid: 17343285
references.citation: Orthop Traumatol Surg Res. 2011 Jun;97(4):410-7
references.pmid: 21570928
references.citation: J Orthop Res. 2010 Jul;28(7):900-6
references.pmid: 20108346
references.citation: Arthritis Res Ther. 2010;12(3):211
references.pmid: 20602810
references.citation: Knee. 2006 Mar;13(2):87-92
references.pmid: 16515862
references.citation: Arthritis Rheum. 2004 Sep;50(9):2811-9
references.pmid: 15457449
references.citation: Curr Opin Rheumatol. 2005 Mar;17(2):195-200
references.pmid: 15711235
references.citation: Curr Opin Orthop. 2005 Oct;16(5):354-362
references.pmid: 17710194
references.citation: Clin Orthop Relat Res. 2000 Nov;(380):85-90
references.pmid: 11064977
references.citation: Clin Med Insights Arthritis Musculoskelet Disord. 2013 May 13;6:19-28
references.pmid: 23761985
references.citation: J Bone Joint Surg Am. 2005 Jul;87(7):1487-97
references.pmid: 15995115
references.citation: Int J Clin Exp Med. 2011;4(4):285-98
references.pmid: 22140600
references.citation: J Appl Biomech. 2013 Dec;29(6):647-54
references.pmid: 23271045
references.citation: Knee Surg Sports Traumatol Arthrosc. 2013 Nov;21(11):2629-37
references.pmid: 23397420
references.citation: Ann Rheum Dis. 2004 Mar;63(3):269-73
references.pmid: 14962961
references.citation: Scand J Med Sci Sports. 1998 Dec;8(6):432-8
references.pmid: 9863982
references.citation: Arthritis Care Res (Hoboken). 2013 May;65(5):703-11
references.pmid: 23203864
references.citation: Arthritis Rheum. 2004 Aug 15;51(4):635-41
references.pmid: 15334438
references.citation: Am J Sports Med. 1997 Nov-Dec;25(6):873-81
references.pmid: 9397280
references.citation: Med Sci Sports Exerc. 2008 Feb;40(2):215-22
references.pmid: 18202582
references.citation: Osteoarthritis Cartilage. 2009 Nov;17(11):1393-401
references.pmid: 19426849
references.citation: Am J Sports Med. 2011 Jan;39(1):64-70
references.pmid: 20833833
references.citation: Clin Orthop Relat Res. 2003 Nov;(416):154-63
references.pmid: 14646755
references.citation: Arthritis Rheum. 2005 Aug;52(8):2386-95
references.pmid: 16052587
references.citation: Nat Rev Drug Discov. 2005 Apr;4(4):331-44
references.pmid: 15803196
references.citation: Ann Intern Med. 2000 Sep 5;133(5):321-8
references.pmid: 10979876
references.citation: J Bone Joint Surg Am. 1986 Jan;68(1):71-9
references.pmid: 3753605
references.citation: Case Rep Orthop. 2012;2012:297326
references.pmid: 23304590
references.citation: J Bone Joint Surg Br. 1992 Mar;74(2):247-50
references.pmid: 1544962
references.citation: J Bone Joint Surg Am. 2009 Feb;91 Suppl 1:95-101
references.pmid: 19182033
references.citation: Med Devices (Auckl). 2013 May 17;6:69-76
references.pmid: 23717052
references.citation: Rheumatology (Oxford). 2008 Oct;47(10):1452-60
references.pmid: 18495820
references.citation: Orthop Rev (Pavia). 2013 Feb 22;5(1):e2
references.pmid: 23705060
references.citation: Clin Orthop Relat Res. 2006 Jan;442:39-44
references.pmid: 16394737
references.citation: J Orthop Res. 2000 Jan;18(1):109-15
references.pmid: 10716286
references.citation: J Bone Joint Surg Am. 2005 Aug;87(8):1706-11
references.pmid: 16085608
references.citation: J Orthop Res. 2011 Jun;29(6):802-9
references.pmid: 21520254
references.citation: Arch Orthop Trauma Surg. 2013 Nov;133(11):1575-8
references.pmid: 23912420
references.citation: Arthritis Rheum. 2006 Oct;54(10):3212-20
references.pmid: 17009255
references.citation: J Electromyogr Kinesiol. 2002 Jun;12(3):205-12
references.pmid: 12086815
references.citation: Med Hypotheses. 2005;64(6):1157-61
references.pmid: 15823707
references.citation: Acta Orthop. 2010 Feb;81(1):90-4
references.pmid: 20175656
references.citation: Knee Surg Sports Traumatol Arthrosc. 2013 Jan;21(1):96-112
references.pmid: 22076053
references.citation: BMJ. 2013 Jan 24;346:f232
references.pmid: 23349407
references.citation: Int Orthop. 2012 Jul;36(7):1399-402
references.pmid: 22354471
references.citation: Acta Orthop Scand. 1994 Dec;65(6):605-9
references.pmid: 7839844
references.citation: Arthritis Rheum. 2003 Aug;48(8):2178-87
references.pmid: 12905471
references.citation: Br J Sports Med. 2009 May;43(5):347-51
references.pmid: 18603576
references.citation: Arch Orthop Trauma Surg. 2004 May;124(4):258-61
references.pmid: 12827394
references.citation: Arthritis Rheum. 2008 Jan;58(1):15-25
references.pmid: 18163481
references.citation: Arthritis Rheum. 1998 Apr;41(4):687-93
references.pmid: 9550478
references.citation: Med Care. 2001 Mar;39(3):206-16
references.pmid: 11242316
references.citation: Am J Sports Med. 2009 Dec;37(12):2318-22
references.pmid: 19864505
references.citation: Am J Sports Med. 2007 Oct;35(10):1756-69
references.pmid: 17761605
references.citation: Orthopade. 2011 Dec;40(12):1103-10
references.pmid: 21713581
references.citation: Am J Sports Med. 1997 May-Jun;25(3):336-40
references.pmid: 9167813
references.citation: J Bone Joint Surg Am. 2012 Jan 4;94(1):77-84
references.pmid: 22218385
references.citation: Med Clin North Am. 2009 Jan;93(1):67-82, x
references.pmid: 19059022
references.citation: Arthritis Rheum. 2004 Mar;50(3):840-8
references.pmid: 15022326