Sunshine Coast Orthopaedic Group

Condition · General

Post-traumatic arthritis.

Arthritis that follows an injury, often decades later. The same disease as osteoarthritis, in a younger patient, in a joint whose anatomy has already been altered.

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Reviewed by Professor Daevyd Rodda Orthopaedic Surgeon · MBBS, Dip. Surg Anat, FRACS, FAOrthA Last reviewed: 21 August 2026

What it is.

Post-traumatic arthritis is osteoarthritis that follows a specific injury. It accounts for a meaningful minority of joint replacements, and a much higher proportion of those performed in patients under sixty.

Three mechanisms drive it, often together:

  • The impact itself. A significant injury damages cartilage cells at the moment it happens, and that damage sets a process running that is not visible for years.
  • Altered mechanics. A fracture that heals with a step in the joint surface, a limb that heals out of alignment, or a joint left unstable by ligament injury all load cartilage in ways it was not built for.
  • Loss of load-sharing structures. Removing meniscal tissue raises contact stress substantially, which is why meniscectomy is associated with later knee arthritis.

The interval is typically long. Twenty to thirty years between an ACL injury in sport and a knee that needs replacing is a common history.

What makes it different.

The arthritis itself behaves like any other osteoarthritis. What differs is the patient and the joint.

The patient is younger. That changes the arithmetic. A replacement at 50 faces more years and more demand than one at 75, so the lifetime chance of needing a revision is higher. It is a reason to exhaust non-operative options thoroughly, not a reason to accept a life limited by pain.

The joint has history. Previous surgery leaves scars, altered soft tissue and often metalwork. Old fractures leave deformity that has to be corrected at the time of replacement. Previous infection has to be excluded before any implant goes in.

Planning a replacement in a previously injured joint.

  • Imaging. Often CT as well as radiographs, to understand deformity, bone stock and the position of retained metalwork.
  • Previous operation records. Knowing exactly what implants are present determines which removal instruments are needed. This is worth chasing before the day rather than discovering in theatre.
  • Metalwork. Screws and plates may need removing, sometimes as a separate earlier operation.
  • Ligaments. A deficient ACL rules out most partial knee replacements, and ligament insufficiency may mean a more constrained implant.
  • Infection. Any previous open injury or surgical infection is investigated before an implant is used.
  • Skin. Old scars influence where the incision can go.

Outcomes are generally good but a little less predictable than replacement for primary osteoarthritis, with somewhat higher rates of stiffness and infection. That is discussed specifically rather than glossed over.

Common questions.

How long after an injury does arthritis appear?

Often decades. Twenty to thirty years between a sporting knee injury and a knee that needs replacing is a common history. Fractures involving the joint surface can produce arthritis considerably sooner.

Could my old injury have been treated better?

Sometimes the arthritis is a consequence of the injury itself rather than of how it was managed. A significant impact damages cartilage at the moment it happens, and that cannot be undone by any treatment afterwards.

Will my old metalwork need to come out?

Sometimes. Screws and plates may sit where a component or stem needs to go. It is identified on imaging beforehand and planned for, occasionally as a separate earlier operation.

Am I too young for a replacement?

Age is a consideration rather than a barrier. A younger patient has more years of exposure and a higher lifetime chance of revision. That is a reason to exhaust other options first, not a reason to endure symptoms that are limiting your life.

Is the operation different?

The principles are the same but the planning is more involved: deformity to correct, metalwork to manage, ligaments to assess and previous infection to exclude. Outcomes are generally good and a little less predictable than for primary osteoarthritis.

References.

  1. Lohmander LS, Englund PM, Dahl LL, Roos EM. The long-term consequence of anterior cruciate ligament and meniscus injuries: osteoarthritis. Am J Sports Med. 2007;35(10):1756-1769.
  2. Anderson DD, Chubinskaya S, Guilak F, et al. Post-traumatic osteoarthritis: improved understanding and opportunities for early intervention. J Orthop Res. 2011;29(6):802-809.

This page provides general information about a medical condition and a surgical procedure. It is not individual medical advice and does not replace consultation with a qualified practitioner. Outcomes vary between individuals and all surgery carries risk. A referral is needed for a consultation with Professor Daevyd Rodda; without one, you can start with the practice nurse practitioner, who can provide it.