Medical Management of Degenerative Joint Disease Flashcards
what happens in the intimal layer of the synovium?
phagocytosis: type A synoviocytes
protein synthesis: type B synoviocytes
why are changes in synovial fluid properties a problem?
less effective boundary lubrication of soft tissues
what are some commonly used medications?
NSAIDs
corticosteroids
hyaluronan
nutriceuticals
orthobiologics
what does interleukin-1 do?
major mediator of cartilage degeneration and destruction
what are the indications for IRAP?
mild to moderate osteoarthritis
capsulitis/synovitis
post-arthroscopic exploration
OCD post-op
post septic arthritis?
what does the subintimal layer do?
blood supply
innervation
what does articular cartilage lack?
vascular, lymphatic, neural supply
relies on synovial fluid for nutrients and waste removal
________________ predominance leads to degenerative joint disease
catabolic
why are changes in synovial fluid properties a problem in joint disease?
reduction in synovial fluid properties
altered cartilage nutrition
less effective boundary lubrication to soft tissues
what can we do to decrease degenerative joint disease?
slow down progression
keep what’s healthy
create/repair tissue as close to normal as possible
reduce inflammation
return catabolic:anabolic ratio
intra-articular vs systemic therapy
what are some NSAIDs?
phenylbutazone
flunixin
surpass: 1% diclofenac sodium
cyclooxygenase inhibitors
what corticosteroids are used?
methylprednisolone acetate/depo medrol
triamcinolone/vetalog
betamethasone/betavet/soluspan
isoflupredone acetate/predef
which corticosteroid has potential chondroprotective properties?
triamcinolone/vetalog
which corticosteroid is long acting?
methylprednisolone acetate
what is IA hyaluronan?
mild anti-inflammatory
legend
what is polyglycan?
combination of hyaluronan and glycosaminoglycans
what is the major component of adequan?
chondroitin sulfate
is a polysulfated glycosaminoglycan
what are the potential adverse effects of polysulfated glycosaminoglycans?
intraarticular use
alterations in coagulation profile
elevation of MICs from some antibiotics in synovial fluid
why are corticosteroids used with hyaluronan in intraarticular injections?
enhance each others effectiveness
decrease negative effects of corticosteroid on cartilage
limited to no evidence
which joints are high motion?
fetlock
stifle
which joints are low motion?
tarsometatarsal joint
pastern joint
what is a natural antagonist to interleukin-1?
IL-1 RA
does not cause a biologic response
what does platelet rich plasma do?
decreases apoptosis and increases autophagy of osteoarthritic chondrocytes
