Post-Traumatic Osteoarthritis

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Post-Traumatic Osteoarthritis Services in Portland, OR, Bellevue, WA, and Tempe, AZ

Post-traumatic osteoarthritis is very common in patients who experience a knee injury, such as a torn meniscus or ACL. Osteoarthritis is both chronic and progressive, resulting in worsening knee pain and dysfunction over time. It can limit one’s abilities and take some of the joy out of life. At Reflex Knee Specialists, our providers offer minimally invasive, non-surgical treatments to help patients remain active and slow the progression of arthritis. Appointments can be scheduled at our offices in Portland, Oregon; Bellevue, Washington; and Tempe, Arizona.

What Is Post-Traumatic


Osteoarthritis is a degenerative joint disease where the soft tissue between the joints, called cartilage, breaks down over time. This progression causes chronic inflammation in the joints, as well as stiffness and swelling.

Post-traumatic means the patient develops osteoarthritis because of an accident or injury. For example, studies have found that knee injuries, such as ACL (anterior cruciate ligament) ruptures, lead to post-traumatic osteoarthritis in 50% of patients within 10 years, and 75% of patients 15 years following the injury. 

Currently, no cure exists for post-traumatic osteoarthritis. However, minimally invasive treatments and lifestyle changes can help relieve painful symptoms, help patients be healthier, and improve their overall quality of life.

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Post-Traumatic Osteoarthritis vs. Primary Osteoarthritis


What distinguishes post-traumatic osteoarthritis from primary osteoarthritis is the cause. With the latter, risk factors such as age, genetics, and obesity are the causes, instead of a knee injury.

A significant knee injury activates biological processes inside the joint, raising levels of pro-inflammatory proteins in the synovial (joint) fluid. In the presence of chronic inflammation, tissues destabilize and break down (degenerate) over time.  This leads to alterations in joint function, which accelerates tissue damage.  Chronic levels of inflammation also trigger an increased number of pain receptors (nociceptors) lining the joint, which is why osteoarthritis becomes increasingly painful over time. 

A characteristic that both types share is the increase of pro-inflammatory proteins, which damage all tissues inside the joint: cartilage, bone, and the lining of the joint, called the synovium.

What Are the Symptoms of Post-Traumatic Osteoarthritis?

The effects of heightened pro-inflammatory protein levels in the joint can be debilitating and impact biomechanical function. Biomechanics refers to how bones, muscles, tendons, and ligaments work together to provide a person with smooth motion. In addition to knee pain, other signs of the condition include:

  • Swelling
  • Stiffness
  • Tenderness
  • Grinding, cracking, or popping
  • Knee instability

Diagnosing Post-Traumatic Osteoarthritis

At Reflex Knee Specialists, the diagnosis begins with a comprehensive knee evaluation. During the appointment, a provider will ask the patient about prior knee injuries, current symptoms, and medical and surgical history. A physical examination will follow to assess range of motion, knee strength, and alignment. This exam also helps the provider to identify painful areas.

Knee specialists use several diagnostic tests to look more closely at knee joints and the surrounding tissues. This helps to confirm diagnoses and can include:

Standing X-rays

As the name suggests, these X-rays are done while the patient stands instead of sitting on an examination table. They allow the provider to assess how much cushioning tissue remains between the femur (thigh bone) and the tibia (shin bone), as well as alignment and changes to the bones such as formation of osteophytes (bone spurs) or sclerosis (increased bone density). 

Diagnostic Knee Ultrasound

A non-invasive and pain-free diagnostic knee ultrasound gives providers a detailed look at the soft tissues inside the knee joint, including the synovium, cartilage, tendons, and ligaments. This advanced imaging modality helps them pinpoint the underlying causes of knee pain.

Treatments for Post-Traumatic Knee Osteoarthritis Treatment

Before making treatment recommendations, providers at Reflex Knee Specialists will consider several factors, including the severity of the patient’s symptoms and how those symptoms impact daily activities. They may recommend one or a combination of the following non-surgical treatments:

Platelet-Rich Plasma (PRP) Treatment

Platelet-rich plasma (PRP) treatment uses a sample of platelets from a patient’s blood to alleviate knee pain and reduce the inflammation inside the joint for several months. PRP also boosts the quality of synovial fluid, providing more cushioning and protection of the cartilage.

Hyaluronic Acid (HA) Injections

Hyaluronic acid treatment (HA) involves injecting a thick gel-like substance called hyaluronic acid into the knee. Like PRP, this treatment will reduce levels of inflammation inside the knee and alleviate pain.  It also provides additional protection and cushion to the joint which can improve the range of motion.

Ozone Joint Therapy

With ozone joint therapy, providers administer ozone into the knee in combination with PRP or HA treatment. Not only does ozone relieve pain and inflammation, it also deactivates proteins that damage the cartilage tissue. Several randomized trials have shown that both HA and PRP treatments provide greater clinical benefit when combined with ozone.

Knee Bracing Systems

The goal of knee bracing is to improve alignment and stability, while decreasing the amount of force over the damaged area inside the knee. When used consistently, a properly fit offloading knee brace will also help decrease pain and inflammation. Knee bracing helps people increase their activity levels and works synergistically with other treatments to help patients achieve their goals.

Physical Therapy

Specialized, knee-focused physical therapy includes multiple exercises and manual techniques to improve knee function and biomechanics. How we stand and move matters, and will impact other areas in the musculoskeletal system; if there is any asymmetry in our movement, it will result in another area becoming strained or damaged. The specialized physical therapy offered at Reflex includes a comprehensive biomechanical evaluation of how all joints are moving and to identify contributors to knee pain; knee pain may be due to an issue in the lower back, hip, ankle, or foot.  Physical therapists at Reflex Knee Specialists take an integrative approach and ensure that patients are moving optimally before any strengthening regimen is started. In addition to helping patients experience less pain, physical therapy can also reduce the risk of future injuries.

Nutritional Supplements

For some patients, nutritional supplements with anti-inflammatory properties can mitigate the symptoms of chronic knee pain. Curcumin and omega-3 fatty acids are a few examples of supplements that providers may suggest for patients.

Exercise Education

Exercise education is particularly beneficial for active people, like athletes. Providers will discuss strategies patients can take to continue their favorite sports and activities. Advice is tailored to each patient’s needs and situations, including their age, health history, and activity level.

Schedule a Knee Evaluation with Reflex Knee Specialists

Patients experiencing recurrent knee pain should be examined by a knee specialist. At Reflex Knee Specialists, our providers have the knowledge and technology necessary to diagnose and treat a variety of knee conditions. To schedule a comprehensive knee evaluation at one of our offices in Oregon, Washington, or Arizona, contact us or call 503-719-6783.

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