Cartilage Flashcards
the collagen that comprises hyaline cartilage is predominantly what type?
type II
how are chondrocytes nourished, since articular cartilage is avascular?
diffusion from synovial fluid
which type of cartilage primarily composes the insertions of tendons/ligaments?
fibrocartilage
what is the type of collagen that is present in fibrocartilage?
type 1
menisci are made of what type of cartilage?
type 1
healing of articular cartilage injuries is enhanced by what?
motion
in a deep articular cartilage lesion, what type of cartilage is involved in the healing response?
type 1 collagen- fibrocartilage
what is the anatomical term for a cartilage outgrowth adjacent to a physis where tendons and ligaments attach?
apophysis
on a t2 weighted image, fibrocartilage is what general color?
dark
on a t2 weighted MRI image, hyaline cartilage is generally what color?
gray
FAI can cause injury to what two structures of the hip joint?
labrum or articular cartilage
what is the most common subtype of FAI?
mixed
what is the most common apophysitis of the hip?
ischial tuberosity apophysitis
why is the proximal tibial articular surface less prone to cartilage injury?
overlying meniscus provides protection
what type of non surgical management is appropriate for focal chondral defect of the knee (3 options?)
- hyaluronic acid injection
- steroid injection
- physical therapy
in what surgical treatment option for focal chondral defect of the knee does cartilage get grafted from a non essential bone, cultured, and reimplanted?
autologous chondrocyte implantation
in autologous chondrocyte implantation, what type of cells make it possible for chondrocytes to proliferate once reimplanted?
pluripotent MSCs
in what procedure to treat focal chondral defect of the knee is the result that reimplanted chondrocytes produce hyaline cartilage?
ACI
what is an advantage of osteochondral allograft transplantation over osteochondral autograft transfer?
allograft transplantation allows replacement of viable hyaline cartilage
explain the difference between osteochondral autograft transfer and autologous chondrocyte implantation?
OAT - transfer of patient normal sites of osteochondral tissue, bony healing occurs with fibrous tissue
ACI - patient’s chondrocytes are harvested, cultured, and then reimplanted to produce hyaline like cartilage
what is the typical return to sport time for osteochondral autograft transfer and autologous chondrocyte implantation?
3-6 months
which cartilage injury is characterized by separation of subchondral bone and overlying articular cartilage?
osteochondritis dessicans
what is the typical location of osteochondritis dessicans?
lateral portion of the medial femoral condyle of the knee
osteochondritis dessicans most often occurs in what age group?
10-15 years old
how is a stable osteochondritis dessicans lesion treated in an adolescent?
restricted weight bearing
t/f prognosis for osteochondritis dessicans is best for patients with open physes
true
if surgery is performed for osteochondritis dessicans, what is the typical time for return to play?
3-6 months
name two osteochondroses that occur at traction apophyses of the knees in the skeletally immature
Osgood-Schlatter and Sinding-Larsen-Johansson syndrome
what type of knee strap can be used in the treatment for osgood-schlatter and sinding-larsen-johansson syndrome?
cho-pat strap
what cartilage defect of the ankle is more likely with a history of ankle inversion injury with recurrent lateral ankle instability?
osteochondral lesion of the talus
how is an osteochondral lesion of the talus treated in a skeletally immature patient?
observation with immobilization
what is the name for osteochondrosis of the achilles tendon insertion to the calcaneus?
Sever’s disease
an XR shows sclerosis and flattening of the navicular. what is the most likely diagnosis?
Kohlers disease (osteonecrosis of the tarsal navicular)
what is Freiberg infarction?
osteochondrosis of the second metatarsal head
t/f most patients with Freiberg infarction have a good prognosis with conservative management
true
what is the treatment for Kohlers disease?
activity modification and immobilization
t/f kohlers disease is a self limiting condition that often takes 6-8 weeks to return to play
true
osteochondritis dessicans of the elbow typically involves what bone?
capitellum of the dominant hand
in the case of osteochondritis dessicans of the elbow, what physical exam maneuver should be performed to rule out elbow instability?
posterolateral rotary instability test
what condition is avascular osteochondrosis of the capitellum in young children?
Panner disease
t/f Panner disease is a self limiting condition
true
what is the likely MOI of Panner disease:
lateral compression overuse injury
what type of ulnar variance is a risk factor for Kienbock disease
negative ulnar variance
what is the initial management for Kienbock disease?
activity modification and immobilization
