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PHTY2101 > OA > Flashcards

OA Flashcards

1
Q

What is osteoarthritis?

A

a disease of synovial joints including mechanical, inflammatory, and metabolic factors which results in degeneration of the joint

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2
Q

How many Australians does OA currently affect?

A

10%

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3
Q

Where is OA most commonly seen within the body?

A

knee

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4
Q

Why is nutrition from synovial fluid so important to joints?

A

the region is avascular so it is the only source of nutrition

hence movement and exercise is so important for maintaining joint health

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5
Q

Can collagen be replaced once lost?

A

not adequately

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6
Q

Can proteoglycans be replaced once lost?

A

yes

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7
Q

What is the role of the synovial membrane?

A

remove particulate matter by phagocytosis
provide nutrition
synthesise components of synovial fluid

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8
Q

What is subchondral bone?

A

bone underlying the articular cartilage

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9
Q

What is primary OA?

A

OA not resulting from injury or disease

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10
Q

What are some risk factors of primary OA?

A 
obesity
55-60 years of age 
genetic inheritance (hand & hip OA) 
female (knee OA)
alignment 
inactivity
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11
Q

What is secondary OA?

A

OA that occurs in response to injury or disease

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12
Q

What are some risk factors of secondary OA?

A

injury/trauma
sport
occupation

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13
Q

What is the pain mechanism of OA?

A

primarily peripheral nociceptive

23% experience neuropathic pain

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14
Q

How does OA pain normally present?

A

intermittent & predictable (relating to mechanical)

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15
Q

How is OA diagnosed?

A

> 45 years
activity-related joint pain
no am stiffness or am stiffness <30 minutes

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16
Q

When would we refer a patient for imaging after diagnosing OA?

A

if a more sinister underlying condition is suspected

if it will change our treatment

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17
Q

What imaging can be used for OA?

A

Xray & MRI

18
Q

What is the grading system used for OA based on xray imaging?

A

Kellgren & Lawrence scale

0: no OA
1: doubtful joint space narrowing, possible osteophytes (‘early OA’)
2: mild OA, definite osteophytes, possible JSN
3: moderate, definite JSN, osteophytes, some sclerosis, possible bone contour deformity
4: severe, large osteophytes, no joint space, severe sclerosis, definite bony contour deformity

19
Q

What are the three important regions to look at on an MRI for OA?

A

bone marrow lesions
cartilage lesions
osteophytes

20
Q

What are some clinical features of OA?

A 
gradual onset of symptoms
pain with loading activities
stiffness with prolonged rest
palpation: some swelling, warmth, bony enlargement 
functional impairments 
reduced sleep
reduced quality of life
psychosocial impariements
co-morbidities
instability/giving way
21
Q

What is the Trendelenberg sign? (in regards to hip OA)

A

reduced hip flexion, abduction & internal rotation

22
Q

What are the three pyramids of OA treatment according to Roos 2012?

A

1: education, exercise & weight control
2: pharmacological pain relief, aids & passive treatments given by a therapist
3: surgery

23
Q

What is Nordic walking and how can it benefit those with OA?

A

walking with two hiking poles resulting in a full-body workout

evidence suggests its more effective than strength training for reducing pain and improving function and can have a longer effect

24
Q

True or false… exercise has an effect on OA pain relief similar to NSAIDS?

A

true

25
Q

How can resistance training, directly and indirectly, affect pain and function in those with OA?

A

directly: relief of symptoms
indirectly: increases in muscle strength leading to relief of symptoms

26
Q

What is an acceptable amount of pain during exercise for patients with OA? (on a scale of 0-10)

How quickly should this pain resolve?

A

2-5

should resolve in 24 hours

27
Q

What should we focus on when educating patients with OA?

A

what is OA
what causes & doesn’t cause OA
OA treatment
benefits of physical activity & exercise

28
Q

What does first line treatment entail for patients with OA?

A

education, exercise & weight control

29
Q

What does second line treatment entail for patients with OA?

A

pharmacological pain relief and passive treatment from a physio

30
Q

When do we see the effects of NSAIDS peak in patients with OA?

A

2 weeks

31
Q

How soon are GI issues as side effects of NSAIDS seen in patients with OA?

A

as early as 4 weeks

32
Q

When do the effects of corticosteroid injections typically peak for patients with OA?

A

2 weeks

33
Q

What is the downside to corticosteroid injections for pain relief in patients with OA?

A

cartilage breakdown
accelerated progression of OA
osteonecrosis
rapid joint destruction

34
Q

True or false… physical therapy is more effective in pain relief than corticosteroid injections for patients with OA

A

true

35
Q

What kinds of aids are recommended for those with OA?

A

walking stick, knee brace (both tibiofemoral & patellofemoral), hand orthosis,

36
Q

Why are modified shoes not recommended for those with knee OA?

A

there is insufficient evidence to recommend them

37
Q

What does third line treatment entail for those with OA?

A

surgery

38
Q

When would arthroscopic surgery be indicated?

A

only when there is mechanical locking in the joint

39
Q

Is arthroscopic surgery beneficial for pain relief for those with OA?

A

no

40
Q

When would knee or hip replacement surgery be indicated for patients with OA?

A

when conservative management has failed and there is severe disease

41
Q

How much more likely is someone under 55 to need a revision surgery after a total joint replacement?

A

5 times (than someone over 75)

PHTY2101 (10 decks)

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