# Does joint lavage reduce intraarticular inflammation in high-energy tibial pilon fractures?

> **NIH NIH R21** · HENRY M. JACKSON FDN FOR THE ADV MIL/MED · 2024 · $153,232

## Abstract

PROJECT SUMMARY
 High-energy pilon fractures are associated with an increased risk of post-traumatic arthritis and poor
patient outcomes. The risk of arthritis is over 25% in many series and can be upwards of 50% in more highly
comminuted fracture patterns. Intraarticular fractures result in an increase in the synovial concentrations of
inflammatory cytokines and matrix metalloproteinases. Animal models have demonstrated the irreversible
damage a persistent hemarthrosis may have on cartilage viability suggesting that prolonged exposure to blood
in this highly pro-inflammatory milieu may further exacerbate the chondral damage from the initial injury.
However, the impact of these local inflammatory processes on the risk of post-traumatic arthritis and patient
outcomes remain unclear.
 The long-term goal of our research is to develop treatment modalities including surgical and
pharmaceutical interventions to reduce the risk post-traumatic arthritis and dysfunction following intraarticular
fractures. The objective of this study is to determine the effect of ankle joint lavage on the risk of post-
traumatic arthritis and patient outcomes following high-energy pilon fractures. First, we will obtain synovial fluid
samples from the ankle joint of patients undergoing temporary external fixation of a pilon fracture for cytokine
analysis. Then, we will randomize patients to undergo standard treatment with or without ankle joint lavage at
the time of external fixation. Patients will undergo repeat synovial fluid analysis at the time of definitive fixation
to determine the effect of lavage on the concentration of pro-inflammatory cytokines. Last, patients will be
followed for a period of six months after surgery to determine the impact on functional outcomes.
 The information generated in this study will substantially add to our understanding of the pathogenesis
of post-traumatic arthritis in high-energy pilon fractures.

## Key facts

- **NIH application ID:** 10888317
- **Project number:** 5R21AR081008-03
- **Recipient organization:** HENRY M. JACKSON FDN FOR THE ADV MIL/MED
- **Principal Investigator:** Benjamin M Wheatley
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $153,232
- **Award type:** 5
- **Project period:** 2022-08-05 → 2026-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10888317

## Citation

> US National Institutes of Health, RePORTER application 10888317, Does joint lavage reduce intraarticular inflammation in high-energy tibial pilon fractures? (5R21AR081008-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10888317. Licensed CC0.

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