Abstract
The vast majority of ankle osteoarthritis (OA) is the sequela of a joint injury; it is therefore by definition posttraumatic OA (PTOA). In extreme cases, the precipitating trauma may be an intra-articular fracture of the ankle. The trauma may be more subtle in other cases, such as damage to stabilizing ligaments leading to chronic ankle instability. Abnormal harmful biomechanics, or pathomechanics, explains much of the PTOA risk following a joint injury of the ankle. These pathomechanics arise from joint injury-associated acute mechanical overload, chronic cumulative mechanical overload, and/or altered joint kinematics. This chapter addresses these different pathomechanical states that challenge the ankle joint and can lead to PTOA. It also offers insight into a range of potential ways in which knowledge of the pathomechanical risk can be used to mitigate or prevent PTOA of the ankle.
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