Post-traumatic osteoarthritis (PTOA) is a severely debilitating condition. Pilon fractures of the distal tibia particularly predispose the ankle to PTOA, with over 50% of these patients suffering from PTOA within five years of injury. However, it is not known which patients will develop this condition and which will remain healthy.

As new potential treatments for preventing PTOA arise, testing of their efficacy would be greatly accelerated by capabilities for early detection. Thus, there is a need for an early objective indicator for PTOA risk in patients recovering from tibial pilon fractures.

This study improved upon existing methods for monitoring PTOA initiation and progression, as well as for predicting outcome. A computational model was developed to predict PTOA risk in the ankle based on chronic contact stress elevation and early changes in joint space width. This model used 3D ankle scans acquired from a weight bearing CT scanner and customwritten code to compute contact stresses in the ankle. We were able to find a quantitative relationship between increased contact stresses and PTOA development in the ankle. This capability enables objective predictions of PTOA risk in these patients.

Early predictions for future changes in the joint may help us prescribe the most effective treatment, providing a basis to prevent permanent damage to the cartilage and preserve long-term joint function.