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As joint trauma is a major risk factor for OA, defining the molecular changes within the joint at the time of injury may enable the targeting of biological processes to prevent later disease. Animal models have been used to test therapeutic targets to prevent PTOA. A review of drug treatments for PTOA in rodents and rabbits between 2016 and 2018 revealed 11 systemic interventions, 5 repeated intra\u2010articular or topical interventions, and 5 short\u2010term intra\u2010articular interventions, which reduced total Osteoarthritis Research Society International\u00a0scores by 30%\u201350%, 20%\u201370%, and 0%\u201340%, respectively. Standardized study design, reporting of effect size, and quality metrics, alongside a \u201cwhole joint\u201d\u00a0approach to assessing efficacy, would improve the translation of promising new drugs. A roadblock to translating preclinical discoveries has been the lack of guidelines on the design and conduct of human trials to prevent PTOA. An international workshop addressing this in 2016 considered inclusion criteria and study design, and advocated the use of experimental medicine studies to triage candidate treatments and the development of early biological and imaging biomarkers. Human trials for the prevention of PTOA have tested anakinra after anterior cruciate ligament rupture and dexamethasone after radiocarpal injury. PTOA offers a unique opportunity for defining early mechanisms of OA to target therapeutically. Progress in trial design and high\u2010quality preclinical research, and allegiance with patients, regulatory bodies, and the pharmaceutical industry, will advance this field.<\/jats:p>","DOI":"10.1002\/jor.24982","type":"journal-article","created":{"date-parts":[[2021,1,18]],"date-time":"2021-01-18T05:26:34Z","timestamp":1610947594000},"page":"1152-1163","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Prevention of posttraumatic osteoarthritis at the time of injury: Where are we now, and where are we going?"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4926-3365","authenticated-orcid":false,"given":"Deborah","family":"Mason","sequence":"first","affiliation":[{"name":"Biomechanics and Bioengineeering Centre Versus Arthritis, School of Biosciences Cardiff University Cardiff Wales 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