Though most people associate arthritis with old age, the disorder can also affect young people in their 30s, 20s and even teens.
Troy Smurawa, M.D., Director of Pediatric Sports Medicine at the Children's Health℠ Andrews Institute for Orthopaedics & Sports Medicine, explains how and why arthritis can develop in the younger years.
What causes arthritis at a young age?
One type of arthritis, juvenile arthritis (or juvenile rheumatoid arthritis), is most often caused by an autoimmune disorder. This rare condition affects about 300,000 kids under age 16 in the United States.
However, young people can also develop osteoarthritis, which is the type of arthritis most associated with aging joints. This type of arthritis causes inflammation, pain and damage to the cartilage.
In kids and teens, osteoarthritis can be caused by a joint disorder called osteochondritis dissecans (OCD). In children with this condition, a small amount of bone begins to separate from the bone around it, causing the cartilage to soften. Over time, it can lead to joint degeneration, cartilage deterioration and arthritis. Osteochondritis dissecans is more likely to occur in knees, ankles and elbows, but its cause is unclear.
"OCD is often seen in the more athletic population," says Dr. Smurawa, "but can also be seen in nonathletic children. When it does develop, it can have a varying effect on the cartilage inside the joint."
In some cases, OCD can heal on its own. However, more severe OCD can damage the cartilage, which may result in earlier osteoarthritis. In very severe cases, orthopedic surgeons can use surgical techniques to help the OCD lesion heal and reduce the risk of developing arthritis in the teenage years or early adulthood.
Another cause of osteoarthritis in young people is sports injuries, like kneecap dislocations or ACL tears. When young athletes experience these injuries, they may have microscopic damage to the cartilage that can develop into arthritis within 10 to 15 years.
"When an athlete sustains a significant injury to a joint, particularly the knee or ankle, that injury can actually injure the cartilage," says Dr. Smurawa. "That itself can lead to problems in the future, but an injury can also harm the ligaments."
When ligaments are damaged, it can lead to instability in the joint, says Dr. Smurawa. This instability can also lead to further injuries and damage to the cartilage. That's why it is important that athletes participate in physical therapy and rehabilitation to restore stability and prevent future injuries that could increase the risk of arthritis.
What are the signs of arthritis in teenagers?
The symptoms of arthritis in teenagers and young people start as simple joint pain, particularly in the knees. Teens will have pain, sometimes swelling or sometimes limping without pain.
"Pain and swelling are not usually typical of minor joint injuries," says Dr. Smurawa. "If you have significant pain, swelling or loss of motion, that could indicate some type of arthritis."
If knee pain does not go away on its own or with the help of physical therapy, it may be caused by OCD. If an athlete experiences any knee pain that lasts for weeks or months, they should see an orthopedic specialist and have an X-ray. Early treatment may help prevent injuries from getting worse.
New treatments for arthritis in young people
The best treatment for osteoarthritis in young people is to prevent it altogether. You may be able to reduce your child's risk for sports injuries by having them participate in ACL injury prevention programs that focus on strength and body mechanics.
"The most important thing is to make sure that when athletes participate in sport, they are doing everything they can to prevent acute injury or even overuse injuries," says Dr. Smurawa. "They need to condition and strengthen their body and know the skills of their sport."
Treating cartilage injuries in children is different than in adults because children are still growing, says Dr. Smurawa. Some children's cartilage will continue to heal on its own without treatment, while other children will need surgical care or other treatment.
One new procedure, matrix autologous cultured chondrocyte implantation (MACI), takes the patient's own cartilage cells, expands them and places them in a collagen (protein) membrane. These cells are then implanted in the knee to help restore damaged cartilage.
While MACI technology has been used in Europe for many years, it has only recently been approved in the United States for adults with knee cartilage damage. Soon, this new treatment may be available for children and teens, giving them new options for preventing arthritis in their younger years.
The only pediatric institute of its kind in the region, the Children's Health Andrews Institute for Orthopaedics & Sports Medicine provides convenient access to a full continuum of orthopedic and sports medicine care. Learn more about our orthopedic services.
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