Who Is At Risk of Early Knee Osteoarthritis?

Knee arthritis in young people often result of previous injury

Young woman with early onset knee OA.

Knee arthritis in young people often result of previous injury

Osteoarthritis of the knee is usually thought to affect only senior citizens. That’s because it is often associated with aging, genetics, and gradual wear and tear on weight bearing joints over time. But osteoarthritis — which is marked by joint pain and stiffness — can also affect much younger people.

Research shows a joint injury suffered at any age increases the risk of early onset osteoarthritis. In the knee, for example, sports injuries — such anterior cruciate ligament (ACL) and meniscus (cartilage) tears — are associated with rapid or early onset post-traumatic arthritis, a form of osteoarthritis.

“Because these type of 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,” says William Bugbee, MD, an orthopedic surgeon at Scripps Clinic.

Early diagnosis important

It can take a while for old knee injuries to cause ongoing symptoms. Symptoms can usually be managed but damage to joints can’t be reversed. That is why early diagnosis is critical for effective treatment.

“Medical treatment of knee osteoarthritis in young people does not differ from its management in the general population,” says Dr. Bugbee.

In many cases, people with knee osteoarthritis can make lifestyle changes to help reduce pain, slow progression of the disease and help improve joint function. If symptoms become severe, knee replacement is an option, but this is generally reserved for older adults.

Over the last few decades, management of arthritis in younger individuals has evolved and the field of joint preservation has emerged. This field encompasses aspects of regenerative medicine and newer surgical techniques to restore or replace damaged tissues without resorting to joint replacement.

What causes osteoarthritis (OA)?

More than 30 million people have osteoarthritis or OA in the United States, according to the Centers for Disease Control and Prevention (CDC). Women are more likely to develop OA than men, especially after age 50.

OA is caused by damage or breakdown of joint cartilage between bones. It is the most common form of arthritis or inflammation in the joints. OA most often affects the hands, hip and knee.

While the risk of OA increases with age, there are other risk factors. In addition to age, joint injury, obesity, genetics and anatomical factors can affect who gets OA and the severity of the disease, according to the National Institutes of Health.

Who gets knee osteoarthritis?

Knee osteoarthritis is probably the most common lower extremity joint affected by OA.

“For some people, an ACL or cartilage tear often changes the knee’s structure and how well the joint moves and functions,” Dr. Bugbee says. “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 can lead to painful bone-on-bone contact between the thigh bone and shin bone. Loss of cartilage on the back of the kneecap can also produce nagging knee pain and irritation of the knee joint.

Certain occupational activities and obesity are also risk factors for early knee OA. Knees are weight-bearing joints. Obesity or excess weight can put more stress on knees. Jobs that require heavy lifting while standing, squatting, or crawling can damage knee joints.

Treatment for OA

Cartilage can’t replace itself naturally. Lifestyle changes can help people with knee OA to avoid a joint replacement surgery down the road.

According to the CDC, people with OA can manage their symptoms on their own with help from their doctors.

Therapies include:

  • Weight loss
  • Low-impact exercises and physical activity. (Cycling has shown to be effective in improving knee arthritis symptoms.)
  • Physical therapy with exercises to strengthen muscles that support the knee
  • Over-the-counter pain relievers, knee injections or prescription medications
  • Supportive devices, such as braces or canes
  • Surgery, if other options have not been effective

“If nonsurgical treatments have been unsuccessful, you may be ready to consider a knee replacement,” Dr. Bugbee says.

“Knee replacement has proven to be highly effective and modern techniques have improved the surgical experience, function, and durability,” he says.

“We now have many other surgical joint preservation options for younger active people suffering from damaged knees.”

Infographic: Sports injuries that can lead to early onset of knee osteoarthritis

Infographic for sports related injuries and early onset of knee osteoarthritis.

Athletes and weekend warriors who experience serious knee injury may be up to five times more likely to develop osteoarthritis (OA) later in middle age (45-65). OA is more prevalent in men under 50 than women, and more prevalent in women over 50 than men.

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