Cartilage injuries

Question 1

What is hyaline cartilage?

Answer 1

Covers the surface of bones in synovial joints and decreases friction and distributes load

Question 2

What is hyaline cartilage composed of?

Answer 2

Water,collagen,proteoglycans and chondrocytes

(chondrocytes produce collagen,PGs and enzymes and enzymes to regulate the extracellular matrix)

Question 3

What is the hyaline cartilage nutrition from?

Answer 3

Synovial fluid and subchondral bone

Question 4

What type of strength do collagen fibres give?

Answer 4

tensile strength

Question 5

proteoglycans are highly hydrophilic- they catlike balloons to give ______ ____

Answer 5

compressive strength

Question 6

Articular cartilage defects can be ______ or _______

Answer 6

traumatic

atraumatic

Question 7

What is included under atraumatic articular cartilage defects

Answer 7

Osteochondritis dissecans
osteoarthritis
inflammatory arthritis

Question 8

Only ___ thickness injuries can heal

Answer 8

full

Question 9

Healing is with _____ which has greater friction and is less wear resistant

Answer 9

fibrocartilage

Question 10

What is osteochondritis dissecans

Answer 10

an area of the surface of the knee loses its blood supply and cartilage +- bone can fragment off

It is most common in adolescents

Question 11

What is the treatment for osteochondritis dissecans

Answer 11

can heal or resolve spontaneously

if detaching on MRI can pin in place- If detached can fix or remove

May benefit from cartilage regeneration in more severe cases

Question 12

Cartilage regeneration techniques

Answer 12

All heal with fibrocartilage
- has higher friction and is less water resistant

Better for smaller defects, unsuccessful in patellofemoral joint.

Question 13

What are the options for cartilage regeneration techniques?

Answer 13

Drilling/microfracture
Osteochondral autograft/allograft
Mosaicplasty
MACI-membane induced autologous chondrocyte implantation

Question 14

What is the cheapest and simplest technique for cartilage regeneration?

Answer 14

Microfracture

Question 15

What technique is used for larger defect or bone loss

Answer 15

Osteochondral allograft

Question 16

how many years benefit does a cartilage regeneration tend to provide

Answer 16

5

Question 17

What disease process can be described as a “imbalance of cartilage breakdown and repair”

Answer 17

OA

Question 18

What may OA be predisposed by?

Answer 18

Injury-articular cartilage injury, fracture,joitn instability
Malalignment-Genu vacuum or valgum,fracture malunion
Degenerate meniscal tear
Infection
also familial/genetic influences

Question 19

What are the non operative treatments for early OA

Answer 19

WT loss
stick
exercise
analgesics
activity modification

Question 20

In OA when are steroid injections used?

Answer 20

only for acute flare ups

Question 21

What is useful in various knee with isolated early medial compartment OA

Answer 21

Osteotomy

Question 22

Who is eligible for knee replacement?

Answer 22

only for older patients with end stage arthritis

-disappointing results in early OA
If younger then poorer outcomes and higher failure
-partial knee replacements have poorer results than total knee replacement

Question 23

How long does a TKR last

Answer 23

15-20 y

Question 24

What are the risks of knee replacement

Answer 24

Deep infection- occurs in 1%

pain.stiffness,DVT/PE,medical complications