Traumatic arthritis

Traumatic arthritis occurs following an injury, excessive movement or physical trauma such as a penetrating wound. Sports injuries are a common cause of traumatic arthritis.

This results in symptoms which are similar to those caused by most other forms of arthritis. They include pain, inflammation and a build up of fluid around the joint.

This arthritis occurs if there is damage to the ‘articular cartilage’from an accident or injury which causes pain and swelling around the joint and restricts normal mobility.

Treatment for this includes anti-inflammatory drugs, low impact exercise and lifestyle changes, e.g. losing weight if necessary. Surgery is an option in severe cases.

Traumatic arthritis is discussed as follows:

• How does traumatic arthritis occur?
• Causes of traumatic arthritis
• Symptoms of traumatic arthritis
• Diagnosis of traumatic arthritis
• Tests for traumatic arthritis
• Treatment for traumatic arthritis
• Managing traumatic arthritis

How does traumatic arthritis occur?

This occurs following damage to the articular cartilage within a joint, e.g. knee joint which often results in osteoarthritis.

To further understand this here is a quick overview of the articular cartilage.

Articular cartilage

This is the smooth white tissue made from collagen (protein) which is found at the end of the bones – at the point where they connect to each other as a joint.

This cartilage is strong and durable and enables these bones to move in conjunction with each. For example articular cartilage in the knee allows the knee to perform a wide range of movements.

Articular cartilage is described as ‘extravascular’: this means that it is located outside of the body’s vascular system (system of veins and arteries). Blood and other nutrients do not flow through it but are found outside of this tissue.

This is the reason why if this cartilage becomes damaged it then takes a long time to heal.

This cartilage can be bruised, ripped or even torn away from the surface of the bone. If this occurs then small fragments of cartilage can float around inside the joint, causing friction and pain. This can result in extra damage to the joint.

What is important for you to know is if this cartilage becomes damaged, i.e. torn then it will not grow back. Scar tissue forms over areas of damage such as tiny holes but this is no substitute for cartilage.

This tissue is not as strong or long lasting and is unable to support any weight placed on the joint. Plus any damage sustained to the joint such as a sports injury changes the work that joint works. It may be pushed out of alignment which affects the way the rest of the body works.

This then speeds up the rate of wear and tear on that joint.

Causes of traumatic arthritis

This type of arthritis has many causes which include:

• Sports injury
• Car accident
• Blunt force trauma (e.g. hit by an implement)
• Fall
• Injury at work
• Fracture
• Overuse

All of these result in damage to the articular cartilage, resulting in pain, swelling and tenderness. The joint feels stiff and feels unsteady and mobility is generally reduced.

This can lead to other forms of arthritis such as osteoarthritis.

Symptoms of traumatic arthritis

These include the accumulation of fluid in the joint, pain, stiffness and inflammation. There may be some bleeding inside the joint and it will be unable to bear any weight which causes a general instability.

The affected joint feels sore to touch and there is a noticeable lack of flexibility. Normal movement is restricted.

Diagnosis of traumatic arthritis

Visit your GP if you have developed these symptoms. He or she will examine the affected joint and will accompany this with a series of questions about the cause of your condition.

For example, if you have sustained an injury to your knee due to playing sport then mention this to him/her. Provide as many details as you can about the injury as this will help with the diagnosis.

Your GP will want to know the extent of the pain and inflammation; if the pain is mild, moderate or severe; how often it occurs and when; and what triggers it.

You will also be asked about your medical history.

Tests for traumatic arthritis

This is followed by a series of diagnostic tests such as blood tests, X-rays and an MRI/CT scan. These will show the damage and inflammation within the affected joint.

The results of these will determine your treatment.

Treatment for traumatic arthritis

There are a range of options available to you which include medication, e.g. anti-inflammatory drugs, cortisone injections, exercise and surgery.

Anti-inflammatory drugs or ‘non-steroidal anti inflammatory drugs’(NSAID’s) are a popular form of medication for arthritis. They help to reduce the inflammation and pain caused by arthritis.

Cortisone injections are often used to treat a range of conditions such as tennis elbow, carpal tunnel syndrome and tendonitis. They are also prescribed for arthritis. They also reduce any inflammation inside the damaged joint and enable it to move more easily.

These are not a cure for arthritis.

Exercise confers a wide range of benefits such as improved health and fitness. Plus it is great for strengthening and firming bones, tendons and muscles.

Choose a low impact exercise which is unlikely to put pressure on your joints thereby increasing the damage. Walking and swimming are fine. If you are uncertain about a suitable form of exercise then ask your GP for advice.

The aim is to strengthen both the muscles surrounding the joint and the joint itself.

Control your weight: if you are a healthy weight then maintain this via a sensible diet and exercise. But if you are overweight then look at losing any excess pounds as these tend to put an extra strain on your joints. Plus any excess weight will speed up the degeneration in the joints.

If none of these are effective then surgery is the next option. There are procedures such as joint reconstruction, joint replacement or removal of the damaged cartilage which are effective at dealing with the pain and lack of mobility in the affected joint.

Find out more about these options and others in our treatment for arthritis section.

Managing traumatic arthritis

It is important that you seek help for traumatic arthritis as soon as possible. Any delay can lead to long term problems such as osteoarthritis so avoid this if possible.

The treatments mentioned in this section are not ‘cures’: there is at present, no cure for traumatic arthritis but it is possible to minimise the pain and other symptoms of this condition.

This will enable you to live your life they way you want and with little or no restrictions.

For more information visit our living with arthritis section.