Abstract
This retrospective
study explored the association between joint osteophytes and traumatic injuries
and evaluated trauma-responsive nursing interventions in 30 patients with joint
osteophytes. Patients were divided into trauma group (n=15, with history of
joint trauma) and non-trauma group (n=15, without trauma history), with each
group further split into intervention (n=8) and control (n=7) subgroups.
Intervention subgroups received trauma-responsive nursing (injury prevention
education, protective brace fitting, trauma-specific rehabilitation), while
controls received routine care. Primary outcomes included osteophyte severity
(Larsen grade) comparison between groups and post-intervention fall/trauma rate
at 6 months. Secondary outcomes included joint stability score, fear of falling
(FOF) scale and trauma-related emergency visits. Results showed trauma group
had significantly higher initial Larsen grade (2.8±0.7 vs 1.6±0.5, p<0.01).
Intervention subgroups in both groups showed lower trauma rate (trauma group:
12.5% vs 57.1%; non-trauma group: 0% vs 42.9%, p<0.05). Trauma-responsive
nursing reduces traumatic risks in osteophyte patients, with particular benefit
in trauma history cases.
Keywords: Osteophytes; Protective brace fitting; Larsen grade; Fear
of falling
Introduction
Joint osteophytes
increase susceptibility to traumatic injuries due to altered joint biomechanics
and stability, with trauma history itself accelerating osteophyte progression1. The bidirectional relationship creates a
"trauma-osteophyte cycle" that elevates injury risk by 2-3 times
compared to normal joints2. This study investigates this association and
evaluates targeted nursing interventions to break the cycle, addressing the
lack of trauma-focused nursing protocols for osteophyte patients3.
Methods
Study design and
participants
Retrospective analysis of 30 patients with
radiographically confirmed joint osteophytes (knee: 22 cases, ankle: 8 cases).
Inclusion criteria: age 40-75 years; Larsen grade I-IV osteophytes; minimum
1-year follow-up. Trauma group defined as history of joint trauma
(fracture/sprain) within 5 years before osteophyte diagnosis. Exclusion
criteria: inflammatory arthritis, neurological disorders affecting balance.
Grouping & interventions
Routine care (pain
management, basic mobility advice). Added trauma-responsive interventions:
Injury prevention education: Identifying high-risk activities (uneven surfaces,
sudden pivots) and teaching avoidance strategies. Protective brace fitting:
Customized braces for high-risk joints to enhance stability during activity. Trauma-specific
rehabilitation: Balance training (single-leg stance, wobble board
exercises) 3x/week, progressive intensity. Post-trauma care protocol:
Immediate RICE (Rest, Ice, Compression, Elevation) guidance for minor injuries
to prevent exacerbation. Primary: Initial Larsen grade comparison
between trauma/non-trauma groups; 6-month fall/trauma incidence. Secondary:
Joint stability score (0-10), FOF scale (0-20, higher=worse), trauma-related
emergency visits.
Statistical analysis
SPSS 26.0 used for
independent t-tests, χ² tests and Fisher's exact test. p<0.05 was
significant.
Results
Baseline characteristics
Trauma group showed
higher Larsen grade and lower joint stability, with no significant differences
in age/gender within subgroups (Table 1).
Table 1: Baseline
Characteristics
|
Characteristics |
Trauma Group (n=15) |
Non-Trauma Group (n=15) |
p-value |
|
Age (years, x̄±s) |
58.3±9.2 |
56.7±8.5 |
0.61 |
|
Male gender, n(%) |
9(60.0) |
8(53.3) |
0.73 |
|
Affected joint (knee/ankle) |
16/4 |
15/5 |
0.89 |
|
Initial Larsen grade (x̄±s) |
2.8±0.7 |
1.6±0.5 |
<0.001 |
|
Initial joint stability score (x̄±s) |
5.2±1.3 |
7.8±1.1 |
<0.001 |
|
Group |
Intervention (n=8) |
Control (n=7) |
p-value |
|
Trauma Group |
1(12.5%) |
4(57.1%) |
0.049 |
|
Non-Trauma Group |
0(0%) |
3(42.9%) |
0.048 |
Secondary outcomes
Intervention subgroups
showed better stability, lower FOF and fewer emergency visits (Table 3).
Table 3: Secondary Outcomes at
6 Months
|
Outcome |
Trauma Group |
Non-Trauma Group |
p-value (intervention effect) |
|
Joint stability score |
Intervention:7.6±1.0 |
Intervention:8.9±0.8 |
<0.001 |
|
Control:5.4±1.2 |
Control:7.0±1.0 |
- |
|
|
FOF scale |
Intervention:6.2±2.1 |
Intervention:4.1±1.8 |
<0.001 |
|
Control:12.5±3.2 |
Control:9.8±2.7 |
- |
|
|
Emergency visits |
Intervention:0.2±0.4 |
Intervention:0.0±0.0 |
0.021 |
|
Control:1.1±0.7 |
Control:0.7±0.5 |
- |
Discussion
This study confirms
trauma history correlates with more severe osteophytes (Larsen grade 2.8 vs
1.6), supporting mechanical stress as an osteophyte driver4. Trauma-induced
joint instability accelerates osteophyte formation, which further reduces
stability-creating a cycle broken by our interventions5.
Trauma-responsive
nursing reduced injury risk primarily through balance training, which improves
proprioception in osteophyte-affected joints6. Protective braces
provided mechanical support during high-risk activities, while education
targeted behavioural modifications7. Notably, trauma
group intervention benefits were more pronounced, suggesting prior injury
creates modifiable risk factors8.
Limitations include
small sample size and reliance on self-reported trauma history. Future studies
should incorporate objective biomechanical assessments to quantify stability
changes.
Conclusion
Joint osteophytes and traumatic
injuries have a bidirectional association. Trauma-responsive nursing
interventions effectively reduce injury risk, improve stability and decrease
fear of falling, with particular efficacy in patients with prior trauma. These
strategies should be integrated into care for osteophyte patients to prevent
trauma-related progression.
References
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development: a cohort study. J Orthop Res 2021;39(2):321-327.
3. Smith JA, et al. Musculoskeletal trauma prevention in patients
with degenerative joint disease. J Adv Nurs 2022;78(3):678-689.
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2019;15(11):632-643.
5. Kraus VB. The role of joint injury in the development of
osteoarthritis. Curr Opin Rheumatol 2015;27(1):1-7.
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patients with lower extremity osteoarthritis. Br J Sports Med
2020;54(16):953-958.
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Metcalf BR, et al. Effects of knee braces on joint stability in osteoarthritis:
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Snow S, et al. Risk factors for incident radiographic knee osteoarthritis: the
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