Recent data suggest that the risk of paediatric sport injury is high and constitutes a significant public health burden. A concern regarding long-term consequences of youth sports injury is the risk of developing osteoarthritis (OA) at a young age. Based on the available evidence, a link between youth sports injuries, particularly acute injury of the knee and ankle, and OA, is likely. Early OA development and intense participation in high-impact, high-stress elite sports at an early age also may be associated, but follow-up of elite athletes into the early adult years is needed to examine this relationship. Given that some antecedents of early adult-onset OA may be traced to child and adolescent sports injury and related surgery, and perhaps intense training regimens, it follows that efforts to prevent sports-related joint injury should begin during the childhood years. Based on the results of recent research evidence, programmes addressing prevention of youth sports injuries may provide the rewarding results of OA prevention.