Though most people associate arthritis with old age, the disorder can also affect young people in their 30s, 20s and even teens.
John Polousky, M.D., a board-certified orthopedic surgeon with Children's Health℠ Andrews Institute for Orthopaedics & Sports Medicine, says the degenerative disorder can pose major treatment challenges in young, active people and the causes may be more common than many parents think.
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.
"Unfortunately, there's not really anything we can do to prevent OCD," says Dr. Polousky. "We know that kids who are more active seem to experience it more often, almost as if it is a stress fracture in the cartilage."
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.
"While ACL reconstructive surgery does a good job of stabilizing the knee for return to activity, it doesn't seem to prevent long-term arthritis associated with ACL injuries," says Dr. Polousky. "It's the sad secret of ACL injuries that almost everyone who has one will develop 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.
"One of the issues with diagnosing arthritis is that knee pain in kids and adolescents is extremely common just because of their growth and high activity level," says Dr. Polousky.
If knee pain does not go away on its own or with the help of physical therapy, it may be caused by OCD. Dr. Polousky suggests that any knee pain that lasts for weeks or months be evaluated with 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.
"In terms of their child's long-term joint health, parents should ensure children participate in a variety of activities to help prevent overuse injuries," says Dr. Polousky. "While there's no direct evidence, we can prevent osteochondritis dissecans, participating in different activities can help children avoid repetitive stress on certain joints."
Dr. Polousky and his team also participate in research on pediatric cartilage, working to discover the causes of osteochondritis dissecans and possible new treatments.
"Cartilage has to be treated more carefully in a child," says Dr. Polousky. "Treatment should be more aggressive and geared toward preserving the area for a much a longer period."
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.
"We're working on getting it approved for children," says Dr. Polousky. "I think it will be a great help. I think kids will benefit the most from this."
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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