Projected Metabolic Consequences of Post-Traumatic Osteoarthritis and the Aging Population

Abstract

Osteoarthritis (OA) affects a large percentage of older adults. Prevalence of OA in younger adults is growing due to traumatic joint injuries occurring through sport participation. The purpose of this review is to summarize the recent literature linking lower extremity musculoskeletal injuries to post-traumatic osteoarthritis (PTOA), summarize the biomechanical and movement strategy consequences of these injuries, and link these consequences with known metabolic risk factors associated with general OA specifically in the aging population. Approximately 30% of younger adults have radiographic OA within one year after traumatic knee injury. An estimated 50% of individuals with chronic ankle instability will suffer from PTOA. Injuries to lower limb joints can lead to alterations in movement patterns, which may result in detrimental joint loading. This may be contributing to this accelerated development of PTOA. Older age, independent of OA, is also associated with gait alterations as well as greater metabolic cost of movement and greater fatigability. It is hypothesized that individuals suffering from PTOA as younger adults may be at a greater risk for these metabolic consequences due to the accelerated timeframe of OA onset and associated functional declines of older age. The potential consequences of PTOA in lower limb joints paired with advancing age may include gait abnormalities, greater metabolic cost of movement, greater fatigability, and reduced physical activity. Collectively, these factors may contribute to greater cardiometabolic risk and weight gain, and reduced quality of life with older age. Strategies to alleviate and/or delay the progression of OA in younger and middle-aged adults are necessary to help reduce this risk.