9: Arthritis 11- is sport good for your joints? Flashcards

1
Q

Explain the Heuter Volkmann principle

A
  • Bones growth in childhood responds to compression/ stretching of bone in childhoos
    • compression: decreases growth
    • extension: allows growth
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2
Q

How do you call this (right) ?

Where is the weight bared?

A

It is a Varus

  • weight is bared at medial condyle
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3
Q

What do you call this?

What is weight bared in it?

A

Valgus

  • weight is bared at the lateral side of knee
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4
Q

What is the effects of exercise on leg shape?

A

Not quite known but e.g.

  1. Soccer (exercise in general?) in childhood probably leads to varus formation
  2. Valgus often seen in catwalk models (and females due to wider hip)
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5
Q

Explain the raltionship between leg shape deformity and arthritis

A

If uneven weight baring

  • cartilage erosion –> painful
  • arthritis develops at over- stimmulated sites
    • Varus= 2x arthritis in knee
    • Valgus = 1.5 x risk of arthritis
  • Same thing can be observed in hips (if structural abnormalities in hips: unusual weight baring –>
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6
Q

Explain the Wolffs Law of bone formation

A
  1. Bone reacts to load
    • if stress put on it: increase in stress increase bone density and lay down
      • (e.g. surfers knuckles)
    • Bone mass goes down when it is not used
      • Astronautes: loos bone and muscle mass
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7
Q

Explain the Developmental Dysplasia of the Hip (DDH)

  1. What is it?
  2. What are the risk factors?
  3. Treatment
A
  • If in childhood/ development head of femur slips out of fosssa–> no force is applied to hip bone –> no propper bone formation (Wolffs Law)

Risk

  • female
  • breech babies
  • ? IU behaviour

Treatment:

  • try to relocate: bone will form around
  • but : increasese risk of arthritis
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8
Q

How can leg shape deformities be treated?

A

Can be done by Osteotomy (cutting the bone)

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9
Q

Explain the treatent of DHS

A

Via: replacement

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10
Q

What is a Cam impingement?

What is it caused by?

A

By rigerous exercise–> high stress on femoral neck causes increased bone mass formation leading to

  • cam impingement (might be a cause of arthritis)
  • because it has an impact /stress on cartilage and
  • labural tears
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11
Q

What is a Pincher Impingement?

A

Deepening of the hip socket

leading to

  • damage to labrum
  • degeneration and ossification of laburm (two sided
  • damage to cartilage
  • –> Arthritis
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12
Q

What is the most effective way of treat arthritis?

A
  • Exercise
    • exercise is good: cartilage also responds to weight
    • but also depending on loading cycle (e.g. might be fine for 1hr but not 5)
      *
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13
Q

Explain the 4 layered structure of hyaline cartilage

A
  1. Superficial layer
    • for articulation + reducing friction
    • horizontal collagen fibres
  2. Transitional Zone
    • oblique collagen fibres
    • starts to resist compression but also shears side to side
  3. Deep layer
    • Vertical Fibres
    • Resists compression

Tidemark (junction between non-ossefied and ossefied cartilage)

    1. Calcified cartilage
      * barrier function preventing germs etc. from bone getting into joint
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14
Q

What are the long-term problems of an ACL rupture and why?

A

Long term: arthritis because of

  • shift in position of tibia
  • change in weight on cartilage in knee –>
  • Arthitis
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