Chapter 46 - General Evaluation of the Knee Patient Flashcards
what cell marker indicates cell senescence?
B-galactosidase, increased expression in chondrocyte function loss
what has a strong recommendation for
in the clinical practice guidelines?
NSAIDS and tramadol
nsaids first, tramdol for refractory cases
what recommendation does the clinical practice guideline find inconclusive
medial unloader bracing
acetaminophen, opiods, pain patches
CSI
PRP/BMAC etc
what CPG advocates strongly against?
accupuncture
gel injections
what factor is higher in BMAC than PRP?
IL-1
what type of pre-operative evaluation should patients with ankylosing spondylitis undergo?
pulmonary - increased chestwall tightness, fibrotic changes
what location is most common in spontaneous osteonecrosis of the knee?
*90% only involve one joint and only involve one condyle
- most commonly the epiphysis of the medial femoral condyle
where is the most common location for an osteochondritis dessicans lesion?
lateral femoral condyle of young males (15-20yo)
MRI findings in osteonecrosis
serpentine lesions within a well demarcated border is specific to osteonecrosis
good results of non-surgical management have been seen in what forms of osteonecrosis?
SPONK
Transient osteoporosis
postarthroscopic osteonecrosis
NOT in secondary osteonecrosis (eg steroids, etoh, sle, renal disease etc)
secondary osteonecrosis of the knee progresses to OA in what percentge of patients?
80%
charcot arthropathy considerations for tka
- used constrained implants
- outcomes worse for syphilis related charcot than for diabetes related charcot
median time to diagnosis of a DVT post op tka
7 days post op
how long to anticoagulate ppx for tka?
14 days, limited evidence that it is beneficial beyond 2 weeks
