L02. Joint Diseases and Injuries - Arthritis and Joint Replacement Flashcards
Def: Arthritis
Inflammation of the joints
How common is arthritis in adults?
Affects 1 in 4 adults
What are the 2 main types of arthritis
Rheumatoid Arthritis and Osteoarthritis
What is Rheumatoid Arthritis?
Autoimmune disease where the immune system attacks the synovium (somewhat genetic, cause unknown)
What are some symptoms of arthritis?
Inflamed, painful joints, weakness, and fatigue
How does Rheumatoid Arthritis cause pain?
- Inflamed synovium produces excess synovial fluid, causing joint swelling
- Synovium produces abnormal tissue called pannus that grows over cartilage surface
- Cartilage under pannus gets destroyed while pannus takes over, which restricts movement
What is osteoarthritis?
Degenerative joint disease (“Wear and tear” disease)
Which is more common: osteoarthritis or rheumatoid?
Osteoarthritis
- both are more common in women
What does osteoarthritis primarily affect?
The cartilage which causes wear and ulcerations leading to bone-on-bone motion
What contributes to the onset of osteoarthritis?
Weight, poor posture, severity of use, previous joint injury
What are the non surgical treatments for arthritis?
OTC analgesics/anti-inflammatory meds (aspirin, ipubrofen) and prescription medications
Disease affecting medications like immunosuppressants (rheumatoid) and glucosamine (osteoarthritis)
What is the goal of joint replacement surgery and how does it work at a high level?
Goal: relive pain and restore mobility
How it works: Damaged articular surfaces are removed and replaced with artificial materials
What are the 3 components for a joint replacement
- Fixation Components: metal post for insertion into bone
- Articular Surfaces: plastic; slippery and durable
- Adhesion: bone cement to adhere prosthesis to bone
What are some risks associated with joint replacement surgeries?
- Infection
- Loosening
- Dislocation
- Wear
- Breakage
- Impaired Nerve Function
What components make up a hip replacement?
- Proximal femur
- Pelvis
What is the most common reason a joint replacement fails?
Loosening
- bone cement contributes to stress shielding which leads to bone atrophy
What is stress shielding?
Local bone demineralization due to the alleviation of normal weight bearing stresses
How can loosening be prevented?
By doing a cementless replacement
- fixation component is textured and porous in a way that promotes bone ingrowth which naturally fixates to the bone
- better for younger patients because more painful and longer recovery
What components make up a knee replacement?
- Distal femur - metallic component that matches femur
- Proximal tibia - metal backed polyethylene
- Patellar - metal backed polyethylene
Can you use a cementless technique for a knee replacement?
No, cemented is the current standard
What is a uni compartmental knee arthroplasty (UKA)?
A knee replacement that only replaces a portion of the knee joint
What happens to knee ligaments during a knee replacement surgery?
- ACL is cut but includes a tibial insert to provide stability
- keeping/cutting PCL depends on the surgeon
What are the components to a shoulder replacement?
- Humeral stem
- Humeral ball
- Glenoid (socket)
