Integrating pathomechanical risk of post-traumatic oa into the treatment of intra-articular fractures

Increased articular contact stress, resulting from joint incongruity following intra-articular fractures of the distal tibia, contributes to the development of post-traumatic osteoarthritis. We are using finite element-computed contact stress to identify at-risk areas of the joint surface for the purpose of developing custom dynamic orthoses to preferentially unload at-risk areas. Areas of elevated contact stress at the tibio-talar joint were primarily located on the anterior third of the articular surface, which suggests unloading during late stance may be most beneficial.