title: Post-traumatic osteoarthritis of the ankle: A distinct clinical entity requiring new research approaches.
abstract: The diagnosis of ankle osteoarthritis (OA) is increasing as a result of advancements in non-invasive imaging modalities such as magnetic resonance imaging, improved arthroscopic surgical technology and heightened awareness among clinicians. Unlike OA of the knee, primary or age-related ankle OA is rare, with the majority of ankle OA classified as post-traumatic (PTOA). Ankle trauma, more specifically ankle sprain, is the single most common athletic injury, and no effective therapies are available to prevent or slow progression of PTOA. Despite the high incidence of ankle trauma and OA, ankle-related OA research is sparse, with the majority of clinical and basic studies pertaining to the knee joint. Fundamental differences exist between joints including their structure and molecular composition, response to trauma, susceptibility to OA, clinical manifestations of disease, and response to treatment. Considerable evidence suggests that research findings from knee should not be extrapolated to the ankle, however few ankle-specific preclinical models of PTOA are currently available. The objective of this article is to review the current state of ankle OA investigation, highlighting important differences between the ankle and knee that may limit the extent to which research findings from knee models are applicable to the ankle joint. Considerations for the development of new ankle-specific, clinically relevant animal models are discussed. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:440-453, 2017.
authors.affiliation: Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, 930 Campus Road, Ithaca, New York.
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Delco
authors.affiliation: Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, New York.
authors.forename: John G
authors.initials: JG
authors.lastname: Kennedy
authors.affiliation: Nancy E. and Peter C. Meining School of Biomedical Engineering, Cornell University, Ithaca, New York.
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Bonassar
authors.affiliation: Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, 930 Campus Road, Ithaca, New York.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Fortier
mesh_terms: D000818:Animals; D016512:Ankle Injuries / Q000150:complications*; D002358:Cartilage, Articular / Q000293:injuries; D004195:Disease Models, Animal; D006801:Humans; D007718:Knee Injuries / Q000150:complications; D010003:Osteoarthritis / Q000209:etiology*
keywords: PTOA; osteochondral injury; preclinical model; sprain; talocrural