Ultimately, the long-term effects of articular impact injury remain unknown. Impact injury has long been considered an explanation for posttraumatic arthritis. It is an attractive hypothesis because often it is the only explanation we can put forth for why arthritis develops in an injured joint. There has been recent interest in the role of chondrocyte apoptosis in the pathogenesis of osteoarthritis. Chondrocyte apoptosis has also been observed with cartilage impact injury and may provide an explanation for how impact injury leads to osteoarthrosis. This paper reviews impact injury and its association with apoptosis as a potential etiology for posttraumatic arthritis.