Ask An Expert: Joint Trauma and Arthiritis

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Ask An Expert: Joint Trauma and Arthiritis

Question:

Can trauma to a joint cause arthritis?

Answer:

Yes, trauma can cause arthritis. However, it's probably more accurate to say trauma is a risk factor for arthritis, because not everyone with trauma gets arthritis and most people with arthritis cannot blame it on an injury.

Any significant injury or repeated trauma that damages bone near the joint or cartilage (the smooth lining of the joint) can lead to arthritis. It may take years for the arthritis to show up, however. For example, a common sports-related injury is torn cartilage in the knee. While this type of injury is often treated with minor surgery that allows a return to action within a number of weeks or months, these athletes are at risk for osteoarthritis (also called degenerative joint disease) years later. Similarly, osteoarthritis is a likely consequence of any fracture in which the break involves the joint. A fracture some distance from the joint is less likely to cause osteoarthritis.

It is harder to know whether more minor, repetitive trauma is the cause of a person's arthritis. Jackhammer operators are said to have an increased risk of developing wrist arthritis but, again, it doesn't seem to affect everyone with that job. What about assembly line workers, cashiers, or even people typing all day on their computers? The role of this sort of repetitive motion in causing arthritis is much less clear.

Finally, the cause of most arthritis is unknown and may well be the result of more than one cause. For example, people with an inherited tendency to develop osteoarthritis may require only minor trauma to develop the disease; another person without a family history of arthritis might be less likely to suffer with the disease despite significant injury.

For those cases in which a cause of arthritis can be found, trauma is the most common culprit. Protecting the joint from trauma by wearing protective gear or, perhaps, through improved conditioning and training may reduce the risk of arthritis.

Robert Shmerling, M.D., is associate physician and clinical chief of rheumatology at Beth Israel Deaconess Medical Center and an associate professor in medicine at Harvard Medical School. He is an active teacher in the Internal Medicine Residency Program, serving as the Robinson Firm Chief. He is also a teacher in the Rheumatology Fellowship Program and has been a practicing rheumatologist for over 25 years.

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Last updated:	January 24, 2007