Osteoarthritis affects all ages. The etiology of this debilitating disease is multifactorial; however, several genes are linked to osteoarthritis. Sports participation, injury to the joint, obesity, and genetic susceptibility predispose adolescent athletes to the development of premature osteoarthritis. Assessment for the risk of osteoarthritis includes obtaining a family history to detect any genetic predisposition, obtaining body weight and body mass index, and identifying the patient's exercise regime and sports participation. Strategies to prevent the development of osteoarthritis in the adolescent include patient education, exercises to build quadriceps strength, low-impact activities, and the maintenance of a healthy weight. The devastating effects of premature osteoarthritis can be reduced if an assessment for risk of the disease is performed during adolescence.