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Small Animal Surgery > Arthritis and Osteochondrosis > Flashcards

Arthritis and Osteochondrosis Flashcards

1
Q

What is arthropathy?

A

Any joint disease

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2
Q

What is arthrosis?

A

“wear and tear”

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3
Q

What is arthritis?

A

Inflammation within a joint

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4
Q

What is polyarthritis?

A

Inflammation in several joints simultaneously

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5
Q

What is a joint capsule?

A

The sac that encloses a joint

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6
Q

What does the suffix “-rrhaphy” mean?

A

To suture in place

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7
Q

What is imbrication?

A

Surgical tightening

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8
Q

What does the suffix “-plasty” mean?

A

Surgical repair or shaping

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9
Q

What is an osteophyte?

A

Forms at synovial or articular margins

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10
Q

What is an enthesiophyte?

A

Forms at tendon/ligament attachment

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11
Q

What is a joint mouse?

A

Mobile fragment within a joint (A loose osteophyte or a fragment of cartilage)

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12
Q

What does ankylosis mean?

A

Spontaneous fusion of joint

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13
Q

When do you see ankylosis?

A

End stage of joint disease

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14
Q

What is arthrodesis?

A

Surgical fusion of a joint

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15
Q

What is arthrotomy?

A

Incision into a joint

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16
Q

What are the 3 types of joint?

A

Synovial
Fibrous
Cartilaginous

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17
Q

What 2 things do you use to classify arthritis?

A

Inflammatory vs. Noninflammatory

Based on process causing pathology

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18
Q

Why do we classify arthritis?

A

Helps to guide diagnostics and therapy

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19
Q

What 2 major divisions are there in inflammatory arthritis?

A

Infectious

Non-infectious (immune mediated)

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20
Q

How is non-infectious inflammatory arthritis subdivided?

A

Erosive vs. Non-erosive

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21
Q

What 2 major divisions are there in noninflammatory arthritis?

A 
Primary (idiopathic) osteoarthritis
Secondary osteoarthritis (DJD)
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22
Q

What species is primary osteoarthritis more common in?

A

Cats

NOTE: Highly unusual in dogs

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23
Q

What species is secondary osteoarthritis more common in?

A

Dogs

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24
Q

What 2 types of secondary osteoarthritis are there?

A

Developmental (OCD, hipdysplasia)

Acquired (trauma, neoplasia)

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25
What are 3 other names for osteoarthritis?
OA Osteoarthrosis DJD
26
What is osteoarthritis?
Aberrant repair of articular cartilage leading to degradation of articular cartilage Altered subchondral bone metabolism
27
What is synovitis?
Synovial inflammation
28
What is surgical treatment for osteoarthritis?
Salvage procedures
29
What are 3 salvage procedures to treat OA?
Joint replacement/arthroplasty Arthrodesis Amputation
30
How do you treat inflammatory arthropathies?
If septic, arthrotomy | If severe DJD, salvage
31
What is medical treatment for OA?
NSAIDs Weight management Exersice moderation Physical therapy
32
What 4 ways can weight management help with OA?
Reduces signs of arthritis Reduces prevalence Delays or prevents radiographic OA Reduces need for medication/surgery
33
What is the signle most important element of medical OA treatment?
Weight management
34
What do you need to make sure your owners understand about weight management?
It's hard and it takes time
35
How does exercise moderation help in the treatment of OA?
Restriction during acute periods of inflammation helps minimize pain. When inflammation is controlled, moderate exercise helps maintain muscle strength and muscle flexibility and reduces pain.
36
What are 6 different physical therapies that can help with OA?
``` Cold/heat therapy Passiive ROM Massage Swimming Treadmill Acupuncture ```
37
What are symptom-modifying agents?
Things like NSAIDs, Tramadol, Gaba, and steroids (intra-articular)
38
What do you need to remember when giving cats NSAIDs?
They can't metabolize them properly because they need glucuronidation
39
What is an NSAID approved for cats?
Onsior (Robenacoxib)
40
How do disease-modifying agents work?
Promote synthesis over breakdown
41
What are 3 types of disease-modifying agents?
Polysulfated glycosaminoglycan (PS-GAG) Pentosan polysulfate Hyaluronic acid - Synovial fluid NOTE: Good EBM support for PS-GAG and PPS
42
When using disease-modifying agents, what do you need to keep in mind/be careful of?
If animal is on heparin therapy because they are all heparin derivatives
43
What is a neutraceutical?
Food or part of a food that provides medical benefit
44
What are 3 major neutraceuticals?
Glucosamine/chondroitin Omega-3 FA Avocado and soybean unsaponifiables
45
How does glucosamine/chondroitin help with OA?
In vitro, stimulated proteoglycan synthesis of hyaline cartilage matrix NOTE: Efficacy uncertain, but safe
46
How do Omega-3 FAs help with OA?
Analogous to NSAIDs, so may decrease need NOTE: EBM is good
47
How do avocado and soybean unsaponifiables help with OA?
Have been shown to be experimentally protective
48
What is autologous platelet therapy?
Patient platelets are collected, and injected into the involved joint. NOTE: Mechanism is unknown
49
What about stem cell therapy?
It's cheaper than a joint replacement, and lots of studies in horses, but EBM is iffy in dogs.
50
When is a salvage procedure indicated?
When severe DJD NOTE: Not an attempt to cure/fix, just preserve limb/life
51
What do you need to make sure owners understand about salvage procedures?
It's not an attempt to cure/fix the DJD, just preserves the limb.
52
What are 4 salvage procedures?
Joint replacement arthroplasty (GOLD STANDARD) Partial joint excision arthroplasty Arthrodesis Amputation (NOT an arthroplasty)
53
What is the gold standard salvage procedure?
Joint replacement
54
What are the 2 best joints for joint replacement?
Hip | Stifle
55
What is the intent of joint replacement?
To allow/preserve normal joint fxn
56
What is partial joint excision?
Remodeling of the joint without replacement Eg. FHO or glenoid excision
57
What is arthrodesis?
Surgical fusion (ankylosis is slow)
58
Why is arthrodesis better than ankylosis?
Faster More complete Less discomfort
59
What 4 principles do you apply with arthrodesis?
Complete removal of ALL articular cartilage Cancellous bone graft Rigid fixation (usually DCP) Standing angle
60
How long do you need to have an arthrodesis coapted?
6-8 weeks
61
How long can healing of an arthrodesis take?
at least 3 months
62
What is the usualy outcome of an arthrodesis?
High motion joint = peg leg | Low motion joint = minimal effect on gait
63
What is osteochondrosis?
A developmental orthopedic disorder where there is a defect in the endochondral ossification
64
What is endochondral ossification?
Process by which epiphyseal cartilage becomes bone
65
Fact Frog: Osteochondrosis is...
a defect in endochondral ossification
66
When is endochondral ossification typically done?
Around 6 months
67
What is the pathophysiology of osteochondrosis?
Focally thicker cartilage due to failed ossification causes a cleft between calcified and non-calcified bone and forces of normal activity fracture the cartilage
68
Fact Frog: Dissecans or Dessicans?
DissEcans for dissection, not DessIcans for dessicated
69
What is osteochondritis dissecans?
Necrotic cartilage induces repair which starts with inflammation, defect in the joint surface accelerated DJD. NOTE: Pain is a result of inflammation
70
What is the typical signalment of osteochondritis dissecans?
Large breed dogs | Rapid growth, with delayed maturation of bone and relatively little muscle development
71
Who is predisposed to osteochondritis dissecans?
Male, large and giant breed dogs, >20 kg with rapid growth, hereditary
72
What kind of biphasic age distribution do we see with osteochondritis dissecans?
Immature - inflammatory arthritis | Mature - Secondary degenerative disease
73
What can we see on RADs that signifies osteochondritis dissecans?
Flattened caudal humeral head
74
What are the 3 possible treatments for osteochondritis dissecans?
Preventative measures Conservative treatment Surgical treatment
75
What are the 2 preventative measures?
Diet (energy, Calcium and Vit. D) | Exercise restriction
76
When do we use conservative treatment of osteochondritis dissecans?
Small lesion | Young patient
77
What 3 things are included in conservative treatment of osteochondritis dissecans?
Diet/exercise restriction Weight control +/- NSAIDs
78
What is the general recommended treatment for osteochondritis dissecans?
Surgery
79
What are the 3 types of surgery for osteochondritis dissecans?
- Arthroscopic fragment removal with subchondral bone debridement - Replacement of articular cartilage with fibrocartilage (imperfect because of scar tissue) - Osteochondral transplants NOTE: 3D printing is becoming a possibility

Small Animal Surgery (13 decks)

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