Abstract
This retrospective
study explored the association between osteoarthrosis and traumatic injuries
and evaluated trauma-responsive nursing interventions in 50 patients with
osteoarthrosis. Patients were divided into trauma group (n=25, with history of
joint trauma) and non-trauma group (n=25, without trauma history), with each
group further split into intervention (n=13) and control (n=12) subgroups.
Intervention subgroups received trauma-responsive nursing (injury prevention
education, protective brace fitting, trauma-specific rehabilitation), while
controls received routine care. Primary outcomes included osteoarthrosis
severity (Kellgren-Lawrence 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
Kellgren-Lawrence grade (2.9±0.8 vs 1.7±0.6, p<0.01). Intervention subgroups
in both groups showed lower trauma rate (trauma group: 15.4% vs 66.7%;
non-trauma group: 7.7% vs 50.0%, p<0.05). Trauma-responsive nursing reduces
traumatic risks in osteoarthrosis patients, with particular benefit in trauma
history cases.
Keywords: Osteoarthrosis; Trauma-responsive nursing; Kellgren-lawrence
grade
Introduction
Traumatic injuries are
a major concern in patients with osteoarthrosis, as joint degeneration
increases susceptibility to falls and fractures, while trauma itself
accelerates osteoarthrosis progression1. The bidirectional “trauma-osteoarthrosis cycle” is
driven by altered joint biomechanics, muscle weakness and impaired
proprioception, elevating injury risk by 2-3 times compared to individuals
without joint disease2. This study investigates this association and
evaluates targeted nursing interventions to break the cycle, addressing the
lack of trauma-focused protocols for osteoarthrosis patients3.
Methods
Study design and
participants
Retrospective analysis of 50 patients with
radiographically confirmed osteoarthrosis (knee: 35 cases, hip: 15 cases).
Inclusion criteria: age 45-80 years; Kellgren-Lawrence grade I-IV; minimum
1-year follow-up. Trauma group defined as history of joint trauma
(fracture/sprain) within 5 years before osteoarthrosis diagnosis. Exclusion
criteria: inflammatory arthritis, neurological disorders affecting balance and
acute infections.
Grouping & interventions
Control subgroups: Routine care (pain
management, basic mobility advice).
Intervention subgroups:
Added infection-preventive 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.
Outcome measures
• Primary: Initial Kellgren-Lawrence 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 Kellgren-Lawrence grade and lower joint stability, with no significant
differences in age/gender within subgroups (Table 1).
Table 1: Baseline
Characteristics
|
Characteristics |
Trauma Group (n=25) |
Non-Trauma Group (n=25) |
p-value |
|
Age (years, x̄±s) |
62.5±9.3 |
60.8±8.7 |
0.52 |
|
Male gender, n(%) |
14(56.0) |
13(52.0) |
0.78 |
|
Affected joint (knee/hip) |
19(76.0)/6(24.0) |
16(64.0)/9(36.0) |
0.36 |
|
Initial Kellgren-Lawrence grade (x̄±s) |
2.9±0.8 |
1.7±0.6 |
<0.001 |
|
Initial joint stability score (x̄±s) |
5.3±1.4 |
7.9±1.2 |
<0.001 |
Table 2: 6-Month Trauma
Incidence
|
Group |
Intervention (n=13) |
Control (n=12) |
p-value |
|
Trauma Group |
2(15.4%) |
8(66.7%) |
0.004 |
|
Non-Trauma Group |
1(7.7%) |
6(50.0%) |
0.021 |
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:7.5±1.1 |
Intervention:8.8±0.9 |
<0.001 |
|
Control:5.5±1.3 |
Control:7.1±1.1 |
- |
|
|
FOF scale |
Intervention:6.3±2.2 |
Intervention:4.2±1.9 |
<0.001 |
|
Control:12.6±3.3 |
Control:9.9±2.8 |
- |
|
|
Emergency visits |
Intervention:0.2±0.4 |
Intervention:0.1±0.3 |
0.015 |
|
Control:1.0±0.6 |
Control:0.6±0.5 |
- |
Discussion
This study confirms
trauma history correlates with more severe osteoarthrosis (Kellgren-Lawrence
grade 2.9 vs 1.7), supporting mechanical stress as a key driver of joint
degeneration4. Trauma-induced joint instability accelerates
cartilage loss and 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 osteoarthritic 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.
Conclusion
Osteoarthrosis severity
correlates significantly with traumatic injury history. 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 are critical for breaking the trauma-osteoarthrosis
cycle.
References