Outline:
Traumatic arthritis is a disease characterized by articular pain and dysfunction due to degenerative change of articular cartilage, posttraumatic unevenness or unbalanced weight-bearing of articular surface. It often results from overstrain to bones, and malnourishment of bones in weak constitution. Serious damage of articular surface due to trauma and infection, or breaking of smoothness and evenness of articular surface due to intra-articular fracture, or unbalanced weight-bearing of articular surface due to congenital deformity or malunion of fracture can lead to injury of tendon and bone and blockage of stagnant blood. Thus, it will result in articular pain and dysfunction.

Furthermore, insufficiency of the kidney in aged people, or injury of the kidney in protracted diseases, or congenital defect, or acquired malnutrition can lead to deficiency of qi, blood and body fluids. Then the joints are deprived of their warming and nourishing materials, as a result, the injury is obstinate to cure.

Major points for diagnosis
1. There is an obvious traumatic history. It mostly occurs in the joints with a great deal of weight bearing and frequent movement.

2. The main symptoms are arthralgia and articular dysfunction. The pain gets serious after activity and better after rest. In the severe cases, there is muscular atrophy of the sick limb, or arthroncus and hydrarthrosis.

3. X-ray film reveals no marked change at the early stage, or only stenosis of joint space that may gradually become worse and worse, spur formation at the margin of joint, hyperosteogeny and osteosclerosis at weight-bearing parts, decrease in density of epiphysis because of cystic degeneration of its spongy substances.

Herbal therapy
Internal treatment based on syndrome differentiation
(1) Syndrome of blockage of stagnant blood
Main symptoms and signs:
Arthroncus and arthralgia aggravated by movement, difficulty in movement, lassitude, dark tongue, or with ecchymoses and choppy pulse.
    
Therapeutic methods: Promoting blood flow to remove blockage, dredging collaterals to stop pain.
     
Recipe and herbs:
Modified Huoxue Zhitong Decoction. Specifically, Danggui ( Radix Angelicae Sinensis ) 10 g, Chuanxiong ( Rhizoma Ligustici Chuanxiong ) 10g, Moyao (Mgrrha) 10 g, Ruxiang ( Gummi Olibahum) 10 g, Sumu (Lignum Sappan) 10 g, Honghua ( Flos Carthmi ) 10 g, Chishaoyao ( Radix Paeoniae Rubrae ) 10 g, Chenpi (Pericarpium Citri Ret iculatae ) 10g, Yanhusuo (Rhizoma Corgdalis ) 15g, Dilong (Lumbricus ) 15 g, Qinjiao ( Radix Gentianae Macrophyllae ) 10 g and Gancao (Radix Glycyrrhizae ) 3 g.
    
(2) Syndrome of deficiency of qi and blood
Main symptoms and signs:
Dull and aching pain of the joint with heavy feeling aggravated by overstrain, or even deformity, pale complexion, dizziness and vertigo, lassitude, spontaneous sweating, pale tongue with thin white coating and feeble pulse.
     
Therapeutic methods:
Promoting regeneration of tissues by tonifying, dredging meridians to stop pain.
 
Recipe and herbs:
Modified Bazhen Decoction. Specifically, Dangshen ( Radix Codonopsis ) 10 g, Baizhu ( Rhizoma Atractylodis Macrocephalae ) 10 g, Fuling (Poriae) 10 g, Danggui ( Radix Angelicae Sinensis ) 10 g, Shudihuang ( Radix Rehmanniae Praeparata ) 10 g, Baishaoyao (RadixPaeoniaeAlba) 10 g, Jixueteng ( Caulis Spatholobi) l0 g, Chuanxiong (Rhizormz Ligustici Chuanxiong) 10 g, Guizhi (Ramulus Cinnamomi Cassiae) 6 g, Luxiancao (Herba Pyrolae) 10 g, Huainiuxi ( Radix Achyranthis Bidentatae )  10 g,  Ruxiang (Cummi Olibanum) 10 g, Moyao (Myrrha) 10 g and Gancao (Radix Glycyrrhizae ) 5 g.

(3) Syndrome of yang deficiency with cold accumulation
Main symptoms and signs:
Cold body and limbs, sharp arthralgia aggravated by cold, failure in flexion and extension, soreness and cold in the waist and knee, pale tongue with white coating, deep-thready pulse with no force.
    
Therapeutic methods:
Tonifying the kidney and strengthening yang, expelling cold to alleviate pain.
     
Recipe and herbs:
Modified Jingui Shenqi Pill. Specifically, Shudihuang (Radix Rehmanniae Praeparata) 25 g,  Huaishanyao  ( Rhizoma  Dioscoreae )  12 g, Shanzhuyu (Fructus Corni ) 12 g, Zexie ( Rhizorna A1ismatis) 10g, Fuling (Poriae) lOg, Rougui (Cortex Cinnamomi Cassiae ) 10 g, Zhifuzi ( Radix Lateralis Aconiti Praeparata ) 10 g, Jixueteng ( Caulis Spatholobi ) 12 g, Xixin (HerbaAsari) 3 g and Gancao (Radix Glycgrrhizae ) 3 g.

External therapy:
Shangke Xiaoyan Paste is externally applied; or Goupi Plaster or Tianhe Gutong Paste is topically used; or Haitongpi Decoction is used for fumigation and bathing; or Kanli Sands is used for hot compress.

Acupuncture therapy   
Meridian points and Ashi points around the joint may be selected, with the needle retained for 20 minutes; or moxibustion is added, once a day.