Can Injuries Cause Arthritis?

When it comes to joint health injuries can cause long term issues, and whilst most people associate arthritis with old age it is worth noting that injuries can lead to developing arthritis later in life. This type of arthritis known as post traumatic arthritis can effect people of all ages including young active people.

So the short answer is yes, injury can in fact lead to arthritis. Injuries as simple as a jammed finger can put strain on the joint, or more commonly knee or shoulder injuries.

What is Post Traumatic Arthritis?

Post traumatic arthritis is a type of arthritis that comes about as a result of experiencing an injury to a joint. When a joint suffers an injury and does not heal properly it can lead to the deterioration of the cartilage over time.

This deterioration can result in pain, stiffness, and in severe cases, bones scraping against each other.

Post traumatic arthritis can later turn into either osteoarthritis or inflammatory arthritis although osteoarthritis is the more common.

Osteoarthritis Is The Most Common Form

Osteoarthritis is the most common form of arthritis. In the case of post traumatic arthritis the trauma causes the normally smooth and healthy surfaces of the joints to become irregular, leading to accelerated wear and tear of the cartilage.

This type of arthritis is often observed in individuals who have sustained joint injuries most commonly fractures or ligament injuries. The ankle  knee, shoulder fingers and hip are the most commonly affected joints.

Inflammatory Arthritis Can Happen

Inflammatory arthritis is howeever far less common and often arises as a result of an autoimmune reaction that causes high levels of joint inflammation.

Inflammatory arthritis can also develop following an acute traumatic injury to the joints but is generally rare as a result of injury.

The exact mechanisms behind the onset of inflammatory arthritis following joint trauma are still not fully understood.

Symptoms of Post-Traumatic Arthritis

Joint Pain: Persistent pain in the affected joint is a common symptom of PTA. The pain may be dull, aching, or sharp, and it can worsen with movement or activity.

Swelling: Swelling around the joint is another common sign of PTA. The joint may appear visibly swollen and feel warm to the touch.

Stiffness: Patients with PTA may experience stiffness in the affected joint, which can make it difficult to move or fully extend the joint.

Decreased Range of Motion: PTA can lead to a decreased range of motion in the joint. This can limit the ability to perform certain activities and tasks.

Joint Instability: In some cases, PTA can cause joint instability, leading to a feeling of the joint "giving way" or being less reliable.

Grating Sensation: Some individuals with PTA may experience a grating or popping sensation when moving the affected joint. This is often due to the irregular surfaces within the joint.

Tenderness: The joint may be tender to the touch, especially around the areas where the arthritis has developed.

Causes and Risk Factors of Post-Traumatic Arthritis

Joint Injury or Trauma: The primary cause of PTA is a previous injury or trauma to a joint. This injury can be the result of a variety of incidents, including fractures, dislocations, ligament tears, or repetitive stress on the joint.

Articular Surface Damage: When a joint injury occurs, it can damage the articular cartilage, which is the smooth, protective surface that covers the ends of bones within the joint. Damage to this cartilage can lead to the development of arthritis over time.

Risk Factors for Post-Traumatic Arthritis:

Severity of Injury: The more severe the initial joint injury, the greater the risk of developing PTA. High-impact injuries, such as fractures that involve the joint surface or complete dislocations, are more likely to lead to PTA.

Delayed Treatment: Failing to receive prompt and appropriate medical treatment for a joint injury can increase the risk of PTA. Proper management of the injury, including stabilization and rehabilitation, is crucial in reducing the likelihood of arthritis development.

Age: Older individuals may be at a higher risk of developing PTA following joint injuries. The body's ability to repair and regenerate cartilage tends to decrease with age.

Genetics: There may be a genetic predisposition to developing arthritis. Some individuals may have a family history of arthritis, which can increase their risk.Joint 

Alignment and Mechanics: Pre-existing joint misalignment or mechanical issues can increase the risk of PTA. Abnormal joint mechanics can lead to uneven wear and tear on the joint surfaces.

Obesity: Being overweight or obese can increase the risk of PTA. Excess body weight places added stress on the joints, which can accelerate the degenerative process.

Occupational or Athletic Activities: People who engage in activities or sports that place repetitive stress on a particular joint may be at a higher risk of developing PTA in that joint. This is particularly common in athletes and individuals with physically demanding jobs meaning that repetitive strain can also lead to arthritis.

Research has shown that joint injuries substantially increase the risk of developing osteoarthritis.

And this risk continues to get worse as we age and the time after the original injury. In fact the most up to date studies have reported that 20-50% of people who have had joint trauma may develop arthritis which could account for up to 12% of all cases of osteoarthritis.

Diagnosing Post-Traumatic Arthritis

Diagnosing post traumatic arthritis can be challenging as the symptoms overlap with other forms of arthritis or joint conditions. Generally speaking it’s easier to diagnose in younger people who are less likely to have developed other sorts of arthritis.

However, there are several diagnostic methods that healthcare professionals use to determine if post-traumatic arthritis is the underlying cause of a person's symptoms.

Physical Examination and Medical History

During a physical examination a healthcare professional will assess the affected joint looking for swelling stiffness or a limited range of motion.

Imaging Techniques

Imaging techniques such as X-raysor MRI scans can provide detailed images of the joint, allowing healthcare professionals to assess the extent of joint damage and detect signs of arthritis.

Laboratory Tests

Laboratory tests on bodily fluids, such as blood tests or synovial fluid analysis can help identify markers of inflammation and rule out other forms of arthritis.

Synovial Fluid Examination

Whilst it is generally not required in some cases doctors may use a synovial fluid examination to differentiate between different types of arthritis. This is a relatively simple undertaking that involves testing a sample of the fluid from the affected joint and analyzing it for the presence of inflammatory markers or crystals.

Treatment and Management of Post-Traumatic Arthritis

The treatment and management of post-traumatic arthritis depend on the severity of the symptoms and the impact on the individual's daily life. In most cases, the initial treatment focuses on minimizing pain and inflammation and improving joint function. This can include a combination of nonsurgical interventions and lifestyle modifications.

Non-Surgical Interventions

Non-surgical interventions are usually the first line of treatment for post-traumatic arthritis. These interventions aim to alleviate pain, reduce inflammation, and improve joint function. Some common non-surgical treatment options include:

Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) or pain relievers may be prescribed to manage pain and reduce inflammation in the affected joint.

Physical therapy: Physical therapy can help strengthen the muscles around the injured joint, improve range of motion, and reduce the strain on the joint.

Assistive devices: The use of assistive devices such as braces, crutches, or orthotic inserts can provide support to the affected joint and alleviate symptoms.

Weight management: Maintaining a healthy weight is crucial for individuals with post-traumatic arthritis, as excess weight can put additional stress on the joints. Weight loss can help reduce pain and improve joint function.

Low-impact exercises: Engaging in low-impact exercises, such as swimming or cycling, can help improve joint mobility and strengthen the muscles around the joint without putting excessive strain on the affected area, you can find some examples here.

Supplements: Some supplements have been shown to reduce inflammation, such as curcumin, but also addressing certain vitamin and mineral deficiencies can help slow the condition getting worse.

Surgical Interventions

Rarely non surgical interventions may not provide sufficient relief or the joint damage may be very severe. Whilst it isn’t common practice surgical options can sometimes be considered. The specific surgical procedure will depend on the affected joint and the extent of the joint damage. Some common surgical interventions for post-traumatic arthritis include:

Joint reconstruction: In cases where the joint surfaces have become irregular or misaligned, surgical reconstruction may be necessary to restore the normal structure of the joint.Joint replacement: Joint replacement surgery involves removing the damaged joint surfaces and replacing them with artificial components. This procedure is often performed in severe cases of post-traumatic arthritis where joint function is significantly impaired.Debridement: Debridement involves removing loose fragments of cartilage or bone from the joint to reduce pain and improve joint function.

It is important to note that surgical interventions are typically considered when conservative treatments have failed to provide sufficient relief or when the joint damage is severe. A healthcare professional will assess the individual's specific case and recommend the most appropriate treatment option.

Outlook for Individuals with Post-Traumatic Arthritis

The outlook for individuals with post-traumatic arthritis can vary depending on several factors, including the severity of the joint damage, the individual's age, overall health, and the effectiveness of the chosen treatment approach. In a lot of cases post traumatic arthritis can be managed effectively with lifestyle modifications and medical care.

It is important for people with post traumatic arthritis to have regular follow ups to adjust the treatment plan if needed.

Fact Checked By Dr Mark Watson

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