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musculoskeletal and rheumatology > 1a cartilage biology and osteoarthritis > Flashcards

1a cartilage biology and osteoarthritis Flashcards

1
Q

what is osteoarthritis?

A

a disease that affects the whole joint which involves the loss of articular cartilage

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2
Q

what is the most common form of arthritis?

A

osteoarthritis

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3
Q

what is the most common reason for hip/knee replacement surgery?

A

pain caused by osteoarthritis

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4
Q

describe the macroscopic features of articular cartilage?

A

smooth, spoony white

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5
Q

what is the other name for articular cartilage?

A

hyaline

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6
Q

describe the layers/structure of articular cartilage?

A

superficial
transitional/intermediate
deep/radial

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7
Q

what 3 things does the ECM of cartilage contain?

A
  1. proteoglcyans - mainly aggrecan
  2. type 2 collagen
  3. water
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8
Q

what is the most common type of proteoglycan found in articular cartilage?

A

aggrecan

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9
Q

How does aggrecan pull water in/ exterior swelling pressure?

A

it has negative side chains which draws water in

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10
Q

what is the function of type 2 collagen in cartilage?

A

it provides tensile strength + gives architecture

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11
Q

what is the only cell type found in articular cartilage?

A

chondrocyte

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12
Q

how can chondrocytes function at hypoxia?

A

cartilage is avascular tissue, so has no blood supply anyways, so has adapted to survive with little O2

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13
Q

what is true about cell division of chondrocytes?

A

they undergo no cell division after adolescence

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14
Q

why is it problematic that chondrocytes do not undergo cell division post adolescence?

A

bc if injure your articular cartilage, your body is not good at healing it.
your body heals it with fibre cartilage which doesn’t have same functional properties of articular cartilage

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15
Q

what are collagenases?

A

enzymes that breakdown collagen

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16
Q

what are major specific collagenases?

A
  1. MMP 1,8 + 13
  2. MMP 3
17
Q

what does MMP mean?

A

metalloprotienase

18
Q

what is the other name of MMP 3?

A

stromelysin

19
Q

what is an example of a non-specific collagenase?

A

Cathepsin-K

20
Q

what are aggrecanases?

A

enzymes that degrade aggrecan

21
Q

what are the two main types of aggrecanases?

A
  1. MMP
  2. aggrecanases such ADAMTS ( 4 +5)
22
Q

describe the structure of aggrecan

A

looks like toilet brush

23
Q

what can inhibit aggrecanases? (4)

A

intrinsic such as:
1. TIMPS (tissue inhibitor of metalloproteinases)
2. growth factors e.g IGF

extrinsic such as:
1.hormones
2. some drugs

24
Q

what causes ECM loss?

A

excess enzymatic degradation of aggrecan and type 2 collagen. thought to lead to OA

25
Q

how does cartilage maintain its thickness?

A

via mechanical load such as walking/ standing.

hence, lack of physical activity can lead to atrophy of cartilage

26
Q

how does an increase in weight affect the mechanical load on your knees?

A

it causes a 3 fold increase in the pressure exerted on your knees. this is why being overweight is a key risk factor for OA

27
Q

what 4 parts of the joint are affected by OA?

A
  1. articular cartilage
  2. subchondral bone
  3. ligament and soft tissue
  4. synovium
28
Q

explain the pathophysiology of OA?

A

1.get excess enzymatic degradation of type 2 collagen and aggrecan via aggrecanases and MMPs
2. proteoglycans are now fragemented
3. overall, causes water loss and integrity of articular cartilage is lost :(

29
Q

what is likely to be seen in the staining of joint in early OA?

A

loss of proteoglycan staining in superficial zone
fibrillation in superficial zone

30
Q

what is likely to be seen in the staining of joint in established OA?

A

loss of proteoglycan + fissuring in both superficial and intermediate zones of cartilage

31
Q

what are the key risk factors for OA developement?

A

age, obesity, joint injury, family history

32
Q

what’s one of the biggest risk factors for OA?

A

ligament tears attained from injuries significantly increase likelihood of getting OA

33
Q

Is OA more common in men or women/

A

women

34
Q

what are the 3 places in body where OA is most common?

A

knees, hands + hip

35
Q

why is the prevalence of OA increasing?

A

As we have an ageing population and increased levels of obesity

36
Q

how do you diagnose OA?

A
  • joint pain during activity
  • stiffness typically <30 mins
  • loss of function
  • examihnation findings: creptius, bony deformity
37
Q

what feature is commonly associated with hand OA?

A

heberden’s nodes (bony overgrowths found in finger joints)

38
Q

what are the 3 main ways of managing OA as per the NICE guidelines?

A
  1. increase exercise
  2. weight management
  3. providing correct information (e.g how its not inevitable and is not always progressive)
39
Q

What are the surgical options for OA?

A

total joint replacement. v effective surgery (arthroplasty)
reduces pain significantly

musculoskeletal and rheumatology (7 decks)

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