Diseases & Conditions

Post-Traumatic Arthritis

How is post-traumatic arthritis defined and what causes it?

"Arthritis" is defined as inflammation of a joint. The most common cause is wearing out of joint surface cartilage (osteoarthritis). Post-traumatic arthritis is caused by the wearing out of a joint that has had any kind of physical injury. The injury could be from sports, a vehicle accident, a fall, a military injury, or any other source of physical trauma. Such injuries can damage the cartilage and/or the bone, changing the mechanics of the joint and making it wear out more quickly. The wearing-out process is accelerated by continued injury and excess body weight.

What are the symptoms of post-traumatic arthritis?

The symptoms of post-traumatic arthritis include joint pain, swelling, fluid accumulation in the joint, and decreased tolerance for walking, sports, stairs and other activities which stress the joint.

How many people are affected and can post-traumatic arthritis be prevented?

Post-traumatic arthritis causes about 12% of osteoarthritis of the hip, knee, and ankle. This means that it affects about 5.6 million people in the United States. Post-traumatic arthritis cannot be prevented. It can be minimized by preventing injuries. If they cannot be prevented, surgical treatment of the injuries to restore the injured joint to as close to new condition as possible can help. Maintaining as close as possible to normal body weight can also help.

How is post-traumatic arthritis diagnosed?

When you come to your doctor for evaluation of joint pain, he or she will ask you about the history of your problem. Questions will include history of an injury, how and when the joint bothers you, what makes the pain better, and what makes it worse. He or she will ask you about your other medical history. Your doctor will perform a physical examination. X-rays will likely be performed and a CT scan, MRI, or other imaging studies may be ordered. Blood tests may also be ordered.

How is post-traumatic arthritis treated?

Treatment for post-traumatic arthritis starts with weight loss, low impact exercise and strengthening of the muscles surrounding the joint, non-steroidal anti-inflammatory medicines (NSAIDs such as Advil, Aleve, Lodine, Celebrex or one of many others) are often recommended if you can take them. Arthritic joints can also be injected with cortisone or substances called Hylamers which act like artificial joint fluid. All of these measures are aimed at making the joint more comfortable and functional. They do not cure the arthritis.

When the arthritis progresses to the point that these measures are not effective in treating pain and maintaining function, then surgical treatment will be discussed.

Surgical treatment may include debriding ("cleaning out"), reconstructing or replacing the worn out joint surfaces. Post-traumatic arthritis progresses as time goes on, the joint surface wearing out further with more use over the years.

Fortunately, when the nonsurgical treatments are no longer effective, surgical treatment can offer lasting relief.

Any medical or surgical treatment can have side effects or risks. NSAIDs can cause stomach irritation, kidney, or other liver problems. Cortisone can cause elevation of heart rate and blood sugar and should not be given too often. Surgical treatments have risks of infection, damage to surrounding structures, and wearing out or loosening of implants. Also, there is a risk of medical complications such as blood clots, heart attack, stroke, infection, and other problems. Fortunately, all these problems are quite infrequent. Most surgery is very successful in improving pain and function.

After surgery, you can expect some discomfort. You may need to use a sling, crutches, a cane, or a walker temporarily. You can expect your pain relief and function to gradually improve over months after surgery.

Post-traumatic arthritis is not a problem that we can eliminate. We can, however, minimize the symptoms and loss of function it causes for people with medicine, exercise, weight loss, and surgery.

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