Post-traumatic osteoarthritis (PTOA) is a debilitating disease that causes pain and loss of function in affected joints. It occurs most predictably after a severe joint injury such as an articular fracture. PTOA is marked by a loss of cartilage thickness over time. The cartilage deterioration is believed to be initiated by pathomechanical factors such as acute fracture severity and chronic elevated contact stress. There are no treatments shown to stop the progression of OA once it begins;​ physicians can only treat symptoms using treatments such as pain medications, bracing, or walking assistive devices.

Based on patient scans, it is difficult to determine which joints will develop PTOA and which will remain healthy. Typically, KL grading of plain radiographs is used to track PTOA development in the ankle. KL grading is subjective and is insensitive to early PTOA-associated changes. Detecting PTOA earlier will lay the groundwork for future clinical trials that can test new treatments. Early detection will allow doctors to inform patients of possible projections of their prognosis with ankle PTOA.

This study improves an objective outcome metric to track OA development using joint space width (JSW) narrowing. 3D JSW is acquired from WBCT scans that are later manipulated to create the new joint space narrowing metric. Joint space narrowing serves in this context as a surrogate for joint deterioration. The study detailed in this thesis focuses on the relationship between pathomechaincal risk factors and the loss of 3D JSW in the first two years after fracture.