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Pain: What is post traumatic osteoarthritis?
This is a big subject and I anticipate that we will need to expand on this preliminary answer.
Post traumatic arthritis is the increased wear that occurs in a joint as the direct and indirect result of injury. Arthritis is a general term for painful inflammation of a joint. Osteoarthritis is the most common form and is due to wear of the joint surface. It is a process more than a disease and takes place slowly in all joints in all of us. It is complex in its details but the overall concept is simple.
Two or more bones touch each other at a joint. The surfaces that touch are covered with a special layer of slippery, resiliant, hard wearing self lubricating joint surface. It is called articular cartilage and you see it most often on the end of a chicken bone. The end of a drumstick is blueish white, slippery and you can cut it. It's quite unlike the rest of the bone. Normally the joint surface stands up to wear very well but it has one serious "failing"; it doesn't regrow. So worn joint surface is not replaced. Once a joint begins to wear the process tends to continue and speed up as the worn parts of the joint roughen and wear the parts that touch them. The end result is bone denuded of joint surface and bone to bone contact. There is a picture of the inside of an arthritic knee in the glossary. (I will provide a link to it later).
If someone has been injured Osteoarthritis sometimes occurs earlier that would be normally expected. There are five direct and two indirect reasons.
Symptoms of Post Traumatic Osteoarthritis
Long lasting pain and aching in the joint. The pain is often dull rather than sharp and may get better once you get going. Getting out of bed and taking the first few steps after sitting may be the worst. Activity may be possible but you may "pay for it" with increased pain afterwards. There is a mysterious connection with weather which has never been properly explained. Typically there is also loss of range of motion of the joint.
An uneven joint surface because of fractures shows that the joint is at risk for post traumatic osteoarthritis. If the process has started the earliest sign is loss of joint surface with the bones getting closer together. Joint surface doesn't show up on Xrays so you normally see a gap between the bones of a joint.
Later signs of osteoarthritis on Xray include development or spurs at the margin of the joint and cavities in the bone. The ultimate sign on Xray is wear5ing away of the bone.
For most people the treatment of arthritis of whatever origin is medication, exercises, weight control or sometimes bracing. Surgery can be used to evaluate the joint (arthroscopy) or sometimes to remove loose pieces and spurs (debridement). If the process has gone too far then fusion of the joint or joint replacement surgey may be needed. OS are quite reluctant to undertake joint replacement surgery on young people because of the risk of early failure.
Myles Clough Jan 22 2002
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