The Center for Podiatric Care and Sports Medicine

Injury Awareness: Preventing Post-Traumatic Arthritis

Posted by on Thursday, June 5th, 2014

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Post-traumatic arthritis is sort of like running over a nail, says Dr. Joshua Baker, MD, of the VA Medical Center in Philadelphia. Your car may drive for a little while, but eventually the tires will blow out. Damaging a joint makes individuals seven times’ more likely to suffer arthritis in the future, according to the American Academy of Orthopaedic Surgeons.

Roughly 5.6 million Americans suffer from arthritis following an injury like a tear, sprain, or fracture. While this only equates to 15% of the arthritis sufferers overall, researchers are starting to look into what causes arthritis to occur after an injury, with the hopes of preventing it in the future.

injured football player
That old sports injury could come back to haunt you, years later, in the form of post-traumatic arthritis.
Image source: Anthony22 via Wikimedia.org

What Causes Post-Traumatic Arthritis?

Researchers are still discovering some of the hidden causes of post-traumatic arthritis, but generally speaking, it occurs when a bone and its cartilage become damaged, the mechanics of the joint change, and the remaining cartilage wears out more quickly than it should. It makes sense when you think about it: a break in the bone causes a break in the gliding surface of the joint.

We see this condition following:

– Motor vehicle accidents

– Slip and fall accidents

– Physical abuse

– Military injuries

– Sports injuries

When osteoarthritis does develop, it’s treated with exercise, therapy, and pain control, Dr. Casey said. Inflammatory arthritis is treated with medications that work best for that type of arthritis. In cases of severe arthritis, joint replacement may be needed.

New Thoughts about Arthritis Triggers

“The mechanism by which it occurs still has not been fully delineated,” says Dr. Joseph Borrelli Jr., MD, a trauma surgeon at the University of Texas Southwestern Medical Center in Dallas. He adds that researchers are trying to figure out if it’s the mechanical trauma itself that triggers arthritis — or if there is some biological process in the cartilage that triggers cell death.

Dr. Borrelli examined an open joint injury in a rabbit and saw that cartilage thinning was evident after one month of injury. Directly beneath the injury site, excessive new bone growth was observed. This increase in bone volume caused stiffening of the joint and a diminished capacity to absorb shock.

Surprisingly, Dr. Borrelli found that chondrocyte cartilage cells did not die off — but, rather, became metabolically inactive almost immediately following injury. Production of bone morphogenetic protein 2, type II collagen, and proteoglycan all significantly decreased. It doesn’t necessarily take a fracture to shutdown these mechanisms, either. It could just be one single impact.

It is believed that orthopaedic surgeons may one day be able to “rescue” the cartilage before the shutdown occurs or stimulate “sleeping” chondrocytes with an injection to begin producing vital substances again.

Why Doesn’t Everyone Develop PTA?

It’s not really understood why some people develop arthritis following injury, while others do not. For years, researchers posited that some people could be considered “super-healers,” which enable them to bounce back from an injury better than others. But new research indicates that genetics may not matter for future arthritis therapies.

Following a series of recent animal studies, Duke University medical scientists believe they will be able to trigger super-healing properties in anyone’s body using mesenchymal stem cells. “The researchers also thought that a type of mice bred for their super-healing properties would probably fare better than typical mice, but they were wrong,” reports the Arthritis Foundation. It turns out, regular mice (not bred for super-healing genetics) were just as good at repairing themselves when given stem cell treatment.

The delivery of 10,000 typical or super-healer stem cells prevented the mice from developing post-traumatic arthritis. According to Duke researchers, the stem cells “changed the levels of certain immune factors, called cytokines, and altered the bone healing process.” Figuring out how to isolate these specific stem cells and develop enough of them in cultures will be the challenge moving ahead, but the portent for therapy is great.

cartilage engineering
Tissue engineering is a complex process that may take years to develop before post-traumatic arthritis therapies become widely available.
Image Source: Cquan via Wikipedia.org

How to Protect Yourself from Post-Traumatic Arthritis Today

So what do you do if you’ve just broken a bone or injured yourself? Experts say that maintaining a healthy body weight, exercising, and working a job that puts less daily stress on the joints can all go a long way in preventing post-traumatic arthritis development — or at least slowing its progression.

It’s also important that you seek out professional sports injury care right away to discuss the latest treatment options. Sports medicine doctors are using therapies like shockwave treatment and platelet rich plasma injections to stimulate the body’s natural healing processes and encourage the body to regenerate itself.

platelet rich plasma
Platelet rich plasma injections are available now to stimulate healing processes in the body.

Post-Traumatic Arthritis Diagnosis & Treatment in New York

The Center for Podiatric Care & Sports Medicine in New York can diagnose and treat post-traumatic arthritis. Our team of experienced, board-certified podiatrists, podiatric surgeons, and physical therapists work together to ensure you receive top-of-the-line treatment like professional athletes receive. We offer the latest therapies for arthritis pain relief and regeneration, including platelet-rich plasma injections. For your convenience, you may book an appointment at our Manhattan or Westchester office online here.

 

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If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.