Friday, 22 September 2023

Post-Traumatic Arthritis: Osteoarthritis After an Injury

From verywellhealth.com

Early treatment helps prevent chronic symptoms

Post-traumatic arthritis (PTA), or post-traumatic osteoarthritis (PTOA), is caused by injury or accident triggering cartilage bruising and joint inflammation. In severe cases, it can also tear the cartilage from bone resulting in cartilage loss and eventual joint degeneration. It is also known as secondary osteoarthritis (OA) because it is has a secondary cause and is not associated with aging and wear-and-tear on the joints. Post-traumatic arthritis causes pain and even temporary disability, but there are ways of managing.

This article will explain how PTA affects you, as well as its causes, treatment options, and ways to manage it.

 Post-Traumatic Arthritis in the Knee

The good news is post-traumatic arthritis caused by accident or injury typically is temporary, lasting a few months or so. It is different from primary osteoarthritis (OA), which is a chronic condition and the most common form of arthritis.

Prevalence

Post-traumatic arthritis is the cause of an estimated 12% of all cases of osteoarthritis.

PTA can affect any joint that has been injured or experienced a physical trauma. However, osteoarthritis is generally associated with common body parts, including:

  • Knees
  • Hips
  • Shoulders
  • Wrist

Types of Sports and Accidents 

Studies have shown that sports injuries are risk factors for developing osteoarthritis later in life, but they can also be triggers for developing PTA immediately after injury, too.

High-contact sports, or highly physical sports in which contact injuries are likely to occur, cause the most  injuries or accidents leading to PTA injuries or accidents leading to PTA.

These include:

  • Football
  • Soccer
  • Hockey
  • Lacrosse
  • Rugby

Certain injuries are also associated with PTA, which include fractures, cartilage damage, acute ligament sprain, and chronic joint ligament instability. Experts say the most frequent clinically significant injuries are in the anterior cruciate ligament (ACL), the menisci, and the hyaline cartilage.

Examples include:

  • ACL tear (knee): A tear or sprain in the connective tissue linking your femur (thigh bone) and tibia (shinbone)
  • An acute meniscal tear: Knee injury often caused by pivoting
  • Intra-articular fractures: Breaks in bones that cross a joint

Unlike osteoarthritis, which develops over years, PTA will have acute or sudden signs and symptoms. These may appear right away or in the months right after injury. These will tell you whether or not you should speak to a healthcare provider about PTA.

Signs and symptoms of acute post-traumatic arthritis:

Post-traumatic arthritis may also involve internal bleeding due to a high-impact injury. It's important to consult a healthcare provider for a physical exam following a sports injury or accident. They can provide diagnosis and next steps for your situation to reduce inflammation, pain, and, if necessary, bleeding.

This type of osteoarthritis is typically temporary, but it isn't reversible and there is still good reason to seek treatment for PTA. The goal of PTA treatment is to minimize symptoms including inflammation and swelling contributing to pain and loss of joint mobility and function.

Early Treatment Benefits

Early and localized treatment may be an effective way to reduce likelihood of developing chronic PTA after direct joint trauma.

Chronic PTA is when symptoms of post-traumatic arthritis persist or last for six months or more. The transition from a temporary to a permanent condition is linked to severe inflammation. Managing chronic post-traumatic arthritis will involve treating the inflammatory mechanisms causing pain.

Medications for treating pain or inflammation

Many options exist for managing chronic pain. Finding what works best to reduce inflammation and pain may take some trial and error. The following are common options for treating osteoarthritis pain.

  • Analgesics (pain relievers) such as over-the-counter (OTC) Tylenol (acetaminophen) or prescription opioids
  • Nonsteroidal anti-inflammatory medications (NSAIDs) such as aspirin (acetylsalicylic acid), Advil (ibuprofen), Naprosyn (naproxen), and Celebrex (celecoxib) available OTC or in prescription-strength options
  • Corticosteroids or prescription steroidal anti-inflammatories in oral or injection options
  • Natural counterirritants such as capsaicin, menthol, or lidocaine that irritate nerve endings to change the sensation to cold, hot, or itchy and redirect your mind away from the pain

In addition to medication and following any specific treatment recommendations from your doctor or rheumatologist (arthritis specialist), experts suggest managing osteoarthritis of all kinds with exercise and assistive devices that can help support your joint strength, mobility, functioning, and overall health.

Examples include:

  • Exercise that includes a mix of strength-training, range of motion exercises, cardio or aerobic activities, and balancing exercises
  • Weight loss, if necessary, to remove excess pressure on joints
  • Physical therapy and assistive devices like braces for reducing pressure on joints where necessary

Complementary Therapies for Pain

You may need more than one treatment for pain, including at-home complementary therapies for post-traumatic arthritis. According to the National Centre for Complementary and Integrative Health (NCCIH), a growing body of evidence supports the following therapies’ use for short- or long-term pain management:

Surgery

Surgery for PTA may be needed in severe cases that cause persistent symptoms that interfere with quality of life. Surgical options include:

  • Joint fusion, when a plate and screws hold the joint together
  • Joint replacement surgery (arthroplasty), when an artificial joint replaces the damaged one

Post-traumatic arthritis is a secondary type of osteoarthritis caused by direct joint trauma or injury and accident. Symptoms can start right away or emerge in the months after injury. The condition usually is temporary, although symptoms lasting longer than six months indicate it has become a chronic condition. Repetitive and high-impact, high-contact sports are associated with developing osteoarthritis or experiencing post-traumatic arthritis.

Treatment is geared toward reducing physical trauma and inflammation and preventing chronic symptoms. Options include OTC and prescription medications, lifestyle modifications that include a range of exercises, assistive devices where necessary, and complementary therapies.

https://www.verywellhealth.com/post-traumatic-arthritis-7853503 

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