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Some of the components of cartilage degrade..

The huge ‘bottlebrush’ aggrecan do degrade with age. 

Cartilage, without a blood supply, is slow to turnover 
Micro-damage is slow to repair. 
 
I went deep on Cartilage in Newsletter #07..

However, like a 70-year-old marathon runner, cartilage can still work okay. 


Component degradation alone does not account for all of the osteoarthritis we see. 

Other factors must contribute, and some are more obvious than others.
 

Trauma

Direct damage to a joint can lead to secondary osteoarthritis. That makes sense..

A broken wrist or shin bone well away from the joint
..can be held in place with a cast while the fracture heals. 
(a fracture and a break meaning the same thing BTW) 

Held straight enough and once healed..
..there’s unlikely to be any long term joint problem.

I speak from personal experience!
(tell you about that again)

If that same fracture extends into the wrist, knee or ankle joint
..it’s a different story.

The fragments need fixing accurately in place,
..usually with a plate and screws.

Any step in a joint surface will heal
BUT irregularity disrupts the even spread of force.

Increased force in one part of the joint
..leads to inflammation and osteoarthritis over time.

Fractures involving joints, therefore, need near-perfect anatomical reduction.
 

Ruptured ligaments

Another obvious cause.

Disrupt the ACL (anterior cruciate ligament) in the middle of the knee
And less stable everyday joint movement
..leads to irregular forces

..predisposing to inflammation and osteoarthritis over time.

Like tyres skidding on a road, an unstable joint will wear out quicker.
That long term risk needs weighing up when considering ligament reconstruction and the long rehab.


Joint infection

Recovery from joint infection, especially if delayed
..damages cartilage irreversibly.

Again, uneven load, ongoing inflammation and long-term osteoarthritis follows.


Those all count as causes of secondary osteoarthritis 
..but by no means account for the majority of osteoarthritis that we see.
 
So, what does happen to the rest of us..?

I think about this a lot..

I've not had any of the problems I've written about here.. in my hip at least.
(the 4th Newsletter in this Autumn series).

It therefore begs the question I'll go into next week:

Does Osteoarthritis just happen?

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