AFC Arthritis Flashcards

1
Q

Where do bones grow from?

A

Growth plate (epiphyseal plate)

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2
Q

State Hueter-Volkmann’s Law

A

Increased compression at the growth plate slows down longitudinal growth Increased tension at the growth plate speeds up longitudinal growth

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3
Q

Give an example of where Hueter-Volkmann’s Law can be used to correct an abnormality.

A

Eight Growth Plate – if there is abnormal growth on one side of the distal tibial physis you can inset a metal plate with pins on either side of the growth plate to prevent further growth on that side and allow the other side to catch up

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4
Q

What are the three different types of knee alignment?

A

Normal/Neutral - centre of the hip is over the centre of the knee which is over the centre of the foot Varus – bowed legs Valgus – knocked knees

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5
Q

What types of athletes get varus alignment?

A

Footballers

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6
Q

Which part of the knee joint would be loaded most in varus and valgus alignment?

A

Varus = The medial compartment Valgus = The lateral compartment

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7
Q

What are the consequences of varus and valgus alignment?

A

It will wear out the cartilage and cause osteoarthritis Varus x2 increase risk Valgus 1.5x increase risk

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8
Q

What surgical intervention can be performed before the onset of osteoarthritis to realign the knee joint?

A

Osteotomy – this involves taking a wedge out of the tibia to realign the knee joint

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9
Q

State Wolff’s Law.

A

Bone in a healthy person will adapt to the loads under which it is placed This means that cancellous/trabecular/spongy bone aligns along the major stress angles of the bone.

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10
Q

Give an example that illustrates Wolff’s law.

A

Surfer’s knots

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11
Q

What are the two surfaces of the cortical bone?

A

Periosteal surface Endosteal surface

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12
Q

Load on the bones causes an increase in cortical thickness – how is this response to loading different in children compared to adults?

A

Children – have an active periosteum and endosteum so they get increased bone growth at BOTH surfaces Adults – their periosteum is less active – so the response to increased loading is mainly at the endosteal surface

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13
Q

A lot of problems to do with body shape occur in utero. Give an example of such a problem that is associated with 9-10% of cases of osteoarthritis

A

Developmental Dysplasia of the Hip (DDH)

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14
Q

Describe the appearance of the hip joint in someone who had DDH.

A

The hip joint may be higher than normal The acetabulum is shallow and it doesn’t cover much of the femoral head This leads to increased load and wear

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15
Q

Why is it important to spot the deformities of DDH early?

A

If these deformities are caught early, they could realign them and cause a remodelling of the joint to allow normal stance

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16
Q

Name and describe two abnormalities of the hip joint.

A

Cam – bump on the femoral neck (mainly males) Pincer – the acetabulum tries to capture the hip joint so it is much deeper than normal (mainly seen in females)

17
Q

What are the negative consequences of Cam abnormality?

A

Deep flexion will cause repeated impact between the bump on the femoral neck and the acetabular rim This damages the labrum that protects the underlying cartilage in the hip Labrum becomes inflamed and can eventually sheer off This leasd to the wearing away of the cartilage –> osteoarthritis

18
Q

What are the negative consequences of Pincer abnormality?

A

The femoral neck will impact with the deepened acetabular labrum and cause compacting of the femoral head posteriorly (this will cause a contre-coup type erosion of the cartilage on the posterior acetabular surface)

19
Q

Name the two cruciate ligaments of the knee joints and state their roles with regards to sliding at the knee joint.

A

Anterior cruciate ligament – stops the tibia from sliding forwards Posterior cruciate ligament – stops the tibia from sliding backwards

20
Q

What is a synovial joint?

A

A joint covered with hyaline cartilage or fibrocartilage that is surrounded by a fibrous capsule with a synovial membrane on the inside producing synovial fluid to lubricate the joint

21
Q

What is the structural difference between the medial and lateral menisci?

A

The lateral meniscus has a much tighter C shape

22
Q

What are the two main functions of cartilage?

A

Shock absorption Low friction

23
Q

Which type of collagen is found in cartilage?

A

Type 2

24
Q

Describe the arrangement of collagen in the superficial layer and explain why they are arranged like this.

A

Horizontally – resists shear forces

25
Q

Describe the arrangement of collagen in the deep layer and explain why they are arranged like this.

A

Vertically – resists compressive forces

26
Q

What provides the nutrition to the tissue above the tidemark?

A

Synovial fluid

27
Q

What is the downside to the lack of blood supply above the tidemark?

A

This means that if the cartilage superficial to the subchondral bone is damaged, it can’t really heal itself

28
Q

What is the name given to the pattern of fibres that form the collagen network in bone?

A

Arcades

29
Q

What happens to your tibia when the ACL snaps and what other structures will try to hold it in place?

A

It slides forwards The meniscus will try to hold it in place NOTE: if you don’t repair the ACL you will get meniscal tears because they are being strained in trying to keep the femur in place on the tibial plateau

30
Q

Describe the vascularity of the menisci.

A

Only the peripheral 1/3 has a blood supply

31
Q

When does bone loading begin?

A

In utero - the punching and kicking against the uterine wall

32
Q

What are the minisci important for?

A

Preventing arthritis They help to distribute load evenly

33
Q

Label this

A
34
Q

Label this

A
35
Q

Label this

A