Osteoarthritis and Athletes

Why do people under 50 have chronic knee pain?

Why do people under 50 have chronic knee pain?

Osteoarthritis (OA) of the knee is usually thought to affect only senior citizens who’ve put years of wear and tear on their bodies and joints. 

But OA — the loss of cartilage in joints — can also be experienced by younger patients (under 50) if they’ve suffered a serious knee injury, like an anterior cruciate ligament (ACL) tear or meniscus (cartilage) tear in their youth.

Knee injuries early in life

An infographic that shows the worst sports for your knees.

Knee injuries early in life

Because most ACL and cartilage injuries occur in our prime athletic years during high school and college, it’s not uncommon for people in their 40s and 50s to have advanced stages of osteoarthritis. 

In fact, US and Canadian researchers have reported that the risk of knee OA as the result of a knee joint injury at a younger age is high. In their research, about 50 percent of women and men with an ACL or meniscus tear eventually developed knee OA. 

And it can take a while for those old knee injuries to cause ongoing symptoms. Some studies suggest that knee osteoarthritis symptoms can begin 12 to 14 years after ACL or cartilage injuries in younger patients. But the precise causes and length of time for the onset of knee osteoarthritis after an injury can vary.

For some people, an ACL or cartilage tear often changes the knee's structure and how well the joint moves and functions. For other people, a loss of cartilage in the knee provides less cushioning on the joint while walking, jogging or running.

The loss or wearing away of cartilage from these injuries can lead to painful bone-on-bone contact between the thigh bone (femur) and shin bone (tibia). Loss of cartilage on the back of the knee cap (patella) can also produce nagging pain and irritation of the knee joint.

Growing new cartilage

There’s no FDA-approved treatment that can regenerate cartilage, but experimental treatments are increasingly in the news as more patients look for options. A California Senate bill signed into law in October 2017 requires doctors who provide stem cell injections to notify patients that such treatments do not have FDA approval.

“There's a whole gamut of things that fall under regenerative medicine,” William Bugbee, MD, an orthopedic surgeon at Scripps Clinic, told The San Diego Union-Tribune in July 2017. “But there's really nothing scientifically proven to regenerate tissue, particularly in arthritic joints. So the term regenerative medicine is sexy, but it doesn't really describe what we can do clinically.”

Scripps physician scientists and researchers are actively working in the areas of cartilage regeneration and replacement. In the meantime, Scripps orthopedic doctors can help you weigh the pros and cons of other non-surgical and surgical options to restore your knees.