The Death of Articular Chondrocytes after Intra-articular Fracture in Humans

BACKGROUND: In this study, we wished to determine whether chondrocyte death occurs after intra-articular fracture and might thus contribute to the development of posttraumatic arthritis. METHODS: Articular fracture fragments were obtained from 30 patients and the terminal deoxynucleotide transferase-mediated dUTP nick-end labeling assay was used to identify dead or dying cells. RESULTS: Dead or dying cells were identified in all fracture fragments, with an average rate of cell death of 35%. Rates of cell death greater than 90% were seen in 4 of the 30 specimens studied. CONCLUSION: Although rates of apoptosis in osteoarthritis have been reported to average 15%, the rate in this fracture population was more than twice this value (35%). The high rate of cell death noted here may help explain the occurrence of posttraumatic arthritis even in anatomically fixed intra-articular fractures.