Hip-Knee Arthritis and Degenerative Conditions-Arthroplasty

Question 1

physeal cartilage is cartilage found on ___ ___ that are skeletally immature.

fibrocartilage are found at ___ and ____ insertions into bone

fibroelastic cartilage is found on the ____.

articulat/hylan cartilage covers ends of bones forming ___. they are smooth, and low co-efficient of friction.

Answer 1

physeal cartilage is cartilage found on GROWTH PLATES that are skeletally immature.

fibrocartilage are found at TENDON and LIGAMENT insertions into bone

fibroelastic cartilage is found on the MENISCUS.

articulat/hylan cartilage covers ends of bones forming JOINTS. they are smooth, and low co-efficient of friction.

Question 2

biological and mechanical factors of articular cartilage.

Answer 2

biologic factors; collagen, synovial, subchondral bone.

mechanical factors: deformity, instability, abnormal forces.

Question 3

what type of collagen is found on the articular cartilage. what proteins? what cells.

Answer 3

1. water
2. COLLAGEN TYPE II
3. proteoglycans. Provides elastic and compressive strength. porous structure traps and holds water.
4. chondrocytes. secretes proteoglycans and collagen to maintain the cellular matrix.

Question 4

degenerative joint disease can be caused by

• ___ water content • ____ number of chondrocytes • ___ proteoglycan content • ____ collagen

Answer 4

• INCREASED water content • DECREASED number of chondrocytes • DECREASED proteoglycan content • ABNORMAL collagen

Question 5

4 classif features of OA

Answer 5

1. joint space narrowing
2. subchondral sclerosis– white line underneath joint.
3. subchondral cysts
4. osteophyres

Usually, should be smooth contour and even spacing. You can’t normally see cartilage, but that is what causes the even joint space.

Question 6

In classic OA of the hip which range of motion does the patient lose first?
A. Flexion

B. Abduction

C. Internal rotation

D. External rotation

Answer 6

C

Question 7

Causes of Avasscular necrosis

Answer 7

Question 8

this person was having lots of pain in his hips over 3 monhts. he has 30 pack years smoking and has diabetes. he drinks and is on prednisone because of multiplea acute axacervations of asthma. what is going on?

Answer 8

he has AVN

Question 9

what is the classic sign of AVN of the hip

Answer 9

Crescent sign

Question 10

treatments for early AVN

Answer 10

Many options exist but efficacy lacking for
non-arthroplasty options
– Decompression, osteotomy, vascularized fibula – These would be in the setting of early disease

Question 11

treatment for advanced AVN of the hip

Answer 11

arthroplasty.

Question 12

why is revision surgery worse than the original surgery?

Answer 12

revision surgery is associated with higher risks. this often occurs during aspetic loosening when the person gains a lot of weight and wears through the original joint replacement.

revision surgery has a higher risk of infection, DVT, transfusion, stiffness, dislocation, periprosthetic fracture, earil failre.