9: Arthritis 11- is sport good for your joints? Flashcards
Explain the Heuter Volkmann principle
- Bones growth in childhood responds to compression/ stretching of bone in childhoos
- compression: decreases growth
- extension: allows growth
How do you call this (right) ?
Where is the weight bared?
It is a Varus
- weight is bared at medial condyle
What do you call this?
What is weight bared in it?
Valgus
- weight is bared at the lateral side of knee
What is the effects of exercise on leg shape?
Not quite known but e.g.
- Soccer (exercise in general?) in childhood probably leads to varus formation
- Valgus often seen in catwalk models (and females due to wider hip)
Explain the raltionship between leg shape deformity and arthritis
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 –>
Explain the Wolffs Law of bone formation
- 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
- if stress put on it: increase in stress increase bone density and lay down
Explain the Developmental Dysplasia of the Hip (DDH)
- What is it?
- What are the risk factors?
- Treatment
- 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
How can leg shape deformities be treated?
Can be done by Osteotomy (cutting the bone)
Explain the treatent of DHS
Via: replacement
What is a Cam impingement?
What is it caused by?
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
What is a Pincher Impingement?
Deepening of the hip socket
leading to
- damage to labrum
- degeneration and ossification of laburm (two sided
- damage to cartilage
- –> Arthritis
What is the most effective way of treat arthritis?
- 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)
*
Explain the 4 layered structure of hyaline cartilage
- Superficial layer
- for articulation + reducing friction
- horizontal collagen fibres
- Transitional Zone
- oblique collagen fibres
- starts to resist compression but also shears side to side
- Deep layer
- Vertical Fibres
- Resists compression
Tidemark (junction between non-ossefied and ossefied cartilage)
- Calcified cartilage
* barrier function preventing germs etc. from bone getting into joint
- Calcified cartilage
What are the long-term problems of an ACL rupture and why?
Long term: arthritis because of
- shift in position of tibia
- change in weight on cartilage in knee –>
- Arthitis