Hip and Knee Osteoarthritis

Question 1

What changes occur in the cartilage in OA?

Answer 1

1) increased water content
2) alterations in proteoglycans with eventual decrease in amount of proteoglycans
3) collagen abnormalities
4) binding of proteoglycans to hyaluronic acid

Question 2

What are stromelysin and plasmin?

Answer 2

Matrix metalloproteases that are secreted by chondrocytes and degrade cartilage; they are inhibited by tissue inhibitor of metalloproteases (TIMPs)

Question 3

What is true about racial disparities in total joint arthroplasty?

Answer 3

African american males are the least likely to receive total joint replacement when compared to whites and Hispanics

Question 4

Which non-operative treatments carry a strong recommendation from the AAOS?

Answer 4

1) NSAIDs, tramadol for pain
2) PT, education and wellness
3) weight loss (moderate evidence)

Question 5

Which non-operative treatments does the AAOS recommend against?

Answer 5

1) Acupuncture
2) Viscoelastic injections, steroids injections
3) Glucosamine and chondroitin

Moderate evidence against needle lavage and lateral wedge insoles

Question 6

What are some generalizations about UKA vs TKA and patellar resurfacing?

Answer 6

UKA has higher revision rate when compared to TKA

No significant difference in outcomes without resurfacing patella but does have higher reoperation rate