How Certain Knee Injuries May Increase Your Risk for Osteoarthritis

An injury early in life can set you up for arthritis later

For most people with osteoarthritis, the cause of their condition is unclear. But certain factors  are known to increase your risk for osteoarthritis. One of them is an injury from sports or some other trauma.

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Injuries can occur at any joint, but the knee is particularly vulnerable, especially to sports-related injuries. Common knee injuries include:

  • Tears of the anterior cruciate ligament (ACL), which attaches the thigh bone to the shin bone in the center of the knee in a cross-wise fashion.
  • Tears of the meniscus, the C-shaped pieces of cartilage on each side of the knee joint.

How these injuries impact risk for osteoarthritis  is a bit complicated.

ACL tears

The ACL is typically not at risk during straight-ahead activities, like running, swimming or cycling. But a soccer or basketball player who stops quickly and changes direction can suffer an ACL tear. People in strenuous professions, like being a police officer or firefighter, where unexpected actions can put them off balance can also be at risk for a torn ACL.

“The ACL is very important for quick start and stop activities that involve pivoting and changing direction,” says orthopaedic surgeon Lutul Farrow, MD.

Once torn, an ACL can be reconstructed. The surgical procedure, while a big one, is recommended for people who want to return to playing sports or a generally active life.

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Having an ACL tear that was reconnected does not necessarily put you at increased risk for developing osteoarthritis later in life, Dr. Farrow says. But there are important caveats.

People with a torn ACL who elect not to have the surgery and to manage the ACL tear more conservatively do face a higher risk for osteoarthritis.

This is because the meniscus on the inside of the knee is susceptible to tearing. And having a torn meniscus does increase the chances of developing osteoarthritis. In addition, most people (about 70 percent) who tear their ACL also tear a meniscus, usually the one on the outside of the knee.

Meniscal tears

A meniscal tear can accompany an ACL tear, but can also occur by itself, either from a sudden injury or simply aging.

“As we get older, the meniscus becomes more brittle and can tear easily,” Dr. Farrow says.

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The menisci serve a vital function, helping to protect the articular cartilage, which covers the ends of bones. Degeneration of articular cartilage is what leads to osteoarthritis.

In the past, surgeons would repair a torn meniscus by removing the entire structure. They learned that people who had this done quickly developed arthritis. Surgeons now remove only the torn portion and as little as possible.

What you can do

If you’ve suffered a knee injury in the past, particularly a torn meniscus, there are steps you can take to minimize your risk for developing osteoarthritis.

Dr. Farrow suggests keeping your weight under control, avoiding high-impact activities, and strengthening the muscles around the knee and hips, as well as the core muscles. It’s also important to stay physically active, although high-impact sports are not advised.

“Cartilage requires motions for nourishment,” Dr. Farrow says. “When you’re sedentary, cartilage is not getting nourished and muscles weaken, which can contribute to developing arthritis or making symptoms worse.”

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