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Posttraumatic Arthritis

Posttraumatic arthritis is a form of arthritis that results from an earlier injury. Intra articular trauma (injury within a joint) can, years later, lead to a gradual deterioration of the joint surfaces.

While the damage may not always be evident, an injury such as a sprain or fracture can cause articular cartilage damage. A more severe injury may even tear pieces of the cartilage from the bone and require surgical removal. Since cartilage does not grow back, smoothing the jagged and torn edges is the best way to relieve pain and improve joint function. Scar tissue then forms in place of the missing cartilage. This changes joint function and predisposes the patient to posttraumatic arthritis.

Even when an injury does not damage the articular cartilage directly, it can be indirectly affected when the injury - such as a fracture healing in a position slightly different than its initial alignment, or damaged ligaments leading to joint instability - alters the manner in which a joint functions.

Symptoms of posttraumatic arthritis include swelling, tenderness, joint instability, pain and possibly internal bleeding.

Diagnosis
After assessing a patient's history and a physical examination, an X-ray may help show the degree of joint damage. And a series of X-rays can help determine the rate of progression.

Treatment
Treatment is determined based on the affect the arthritis has had on a patient's joints at the time of diagnosis, as well as the type of joint affected. It may involve conservative treatment - including anti-inflammatory medications such as aspirin or ibuprofen, refrain from inflammatory activity, cortisone injections, and rehabilitation and occupational therapy (particularly when affecting hands and fingers).

In more advanced cases joint fusion, or arthrodesis, may be indicated in order to eliminate pain by allowing the bones to grow, or fuse, together. While this reduces range of motion, it is successful in eliminating pain and preventing deformity.

Joint replacement, or arthroplasty, is also an option depending on the health of the patient and advanced stage of the disease.

The earlier the diagnosis, the greater the chance of preventing irreversible damage.