Joint dysfunction and repairs

Question 1

what is the difference between a dislocation and a subluxation

Answer 1

dislocation = displacement of a bone from its natural position in the joint
subluxation = partial dislocation (larger joint sapce than normal)

Question 2

when is the prevalence of dislocations the highest

Answer 2

peaks in young kids and older adults
(low in between)

Question 3

what are the common joints affected by dislocation

Answer 3

synovial joints
- least stable and have the most movement
- ex: patellofemoral, glenohumeral, ankle, hand and finger, etc

Question 4

why would dislocations occur

Answer 4

sports injuries (esp in youth)
accidents / falls
conditions that cause joint hypermobility

Question 5

what is ehlers danlos syndrome (EDS)

Answer 5

group of 13 heritable connective tissue disorders that commonly cause joint hypermobility (hEDS)
- caused by alterations in components of the ECM

Question 6

what is EDS characterised by

Answer 6

skin hyperextendibility
joint hypermobility
poor wound healing
have mutatiosn in the genes encoding collagen type V

Question 7

what is the result of EDS alterations to ECM

Answer 7

alterations in the structure, processing, and production of collagen causes:
- decreases in ligament and tendon stiffness
- can cause dislocation

Question 8

what is osteoarthritis (OA)

Answer 8

characterised by loss of articular cartilage, bone spurs, and joint space narrowing

Question 9

what are the commonly affected joints and risk factors for OA

Answer 9

hips, knees, shoulders, base of bing tose, and base of the thumb
risk factors = family history, aging, obesity, joint malaignment

Question 10

what are the 3 phenotypes of OA

Answer 10

post traumatic / mechanical overload OA
age related OA
metabolic OA
- can be significant overlap between phenotypes, classifications are not hard rules

Question 11

what is PTOA or mechanical overload OA

Answer 11

caused by repetitive mechanical stress or acute joint trauma
- can occur in people <45
- affects hips, knees, ankles, or shoulders

Question 12

what is age related OA

Answer 12

no history of trauma or metabolic syndrome
- occurs in people 65+
- affects the hips, knees, and hands

Question 13

what is metabolic OA

Answer 13

occurs in obese or overweight individuals
history of metabolic syndrome (diabetes mellitus, hypertension, dyslipidemia)
- occurs in people 45-65
- affects the hips, knees, hands

Question 14

what is the difference between a total and partial hip joint replacement

Answer 14

total = femoral head, neck, and pelvis acetabulum replaced
partial = only femoral head and neck

Question 15

what is the most common indication for hip arthroplasty

Answer 15

symptomatic OA
- more than 90% of patients

Question 16

what is the difference between cemented and cementless arthroplasty

Answer 16

cemented = held in place, can also include antibiotics to reduce infection and prevent blood loss
cementless = bone grows back to hold the replacement in place
- doesn’t work well in knee arthroplasties because of loosening of the tibial component

Question 17

what is replaced in a spinal arthroplasty

Answer 17

spinal intervertebral discs

Question 18

why would a spinal arthroplasty be used

Answer 18

in cases of disc degeneration or more severe herniation
- particularily in cases of pain or neuropathy
- considered an alternative / less severe approach to spinal fusion which is more common

Question 19

what is a spinal fusion

Answer 19

surgery to permanently join two or more vertebrae together
- over 325 000 performed every year

Question 20

why would a spinal fusion be done

Answer 20

injury / fracture to vertebrae
weak / unstable spine due to infections / cancer
spondylolithesis (slipping of vertebrae)
scoliosis
arthritis of the spine