8.17 OA Flashcards
factors that predispose to OA
- injuries (single and multiple)
- repetitive actions
- surgeries
- sports
- obesity
- age
predisposing factors for OA: repetitive actions
typically associated with force
predisposing factors for OA: age
historically associated with older people, but now getting younger
What is the hip capsular pattern?
hip flexion » abd » IR
What can cause locking/pseudolocking with OA?
- loose bodies
- bone on bone (osteophytes)
hip OA: location of pain
deep in groin
hip OA: When does it hurt more?
- with activity
- after periods of rest
hip OA: does rest ease pain?
yes
Conducting the exam when you suspect hip OA
- may be better to use distraction to find out if it eases rather than aggravating tests (scour, etc.)
- look at step length and stance time
with hip OA, step length will be
shorter on unaffected side
with hip OA, stance time will be
shorter on affected side
education for hip OA pts
- activity modification (sleeping positions)
- HEP (strengthening around the joint)
- using distraction to decrease pain
What should a strength program for a hip OA pt be focused on?
Greater focus on endurance than large strength gains
Strengthen everything around the joint
How often will you need to see a hip OA pt?
- Won’t see them very often
- Trying to work on functional movements and delay hip replacement
Where does OA start?
inflammation in bone due to microtrauma
Is OA usually symmetrical?
no
Where does OA generally occur the most?
WB joints
- hips
- knees
- spine
In addition to osteophytes, what can also form in the bone with OA?
subchondral cysts
What can osteophyte formation cause? (s/s)
- pain
- bone mice
- limited ROM (anatomical or self-selected)
- loss of alignment
What happens to ligaments with OA?
Get both laxity and tightening that potentiates varus/valgus deformities
What happens in the synovium/capsule with OA?
Capsule is stretched, but is not heavily involved
Generally, this happens to the cartilage with OA
- Thickens at first, then softens
- Thins » lost
Muscle involvement with OA
- Guarding for pain
- Initial placement into varus/valgus
- Compensation
What is the problem with thickening of the cartilage with OA?
- Thickening creates additional compression that exacerbates the OA
- Get compensatory changes to offload the joint
Mental changes with OA pts
Depression: prolonged pain makes them sad and grumpy
High energy expenditure
Heberdeen nodules are located here
DIP joints
Bouchard nodules are located here
PIP joints
