OA and exercise Flashcards
What is the relation between exercise in growth and OA? and shape of joints?
During growth-2 growth plates either side of bones
Hueter-Volkman principle-compressed bones grow less, pulling them grows more
Relevance to sport->Everyone has a different shaped leg (straight, medially deviated (valgus), laterally deviated (verous))-many can be found
Straight-weight bearing on middle of knee on both chondyle. Verous-weight bearing on the medial part of knee (most people start as slightly verous). Valgus-all on the lateral part of knee
Exercise can cause valgus/varus legs when children exercise (if do sports early, tend to be quite bow legged by 18)
footballers tend to be bow legged
Why does shape of joints matter to health and OA?
Shape-
if all the weight in varus/valgus in concentrated on one knee chondyle-> wear and tear of the joint much faster as it has much more weight
Usually OA signs start at the site which has more pressure->both chondyle usually not affected until later in disease
Varus people 2x OA chance
Valgus 1.5 OA chance
WHat is a way to repair abnormal leg shapes?
Osteotomy-surgical removal of bone on tibia to angle the plate of the knee differently-> and correct the angle
What is Wolff’s law?
Bone responds to the stress put on it
More stress put, the more bone will be laid
Less stress put/use->bone wastes away (astronauts)
What is developmental dysplasia of the Hip?
Application of Wolff’s law
In babies-> need ball of the femur to be in the socket-> and that causes the necessary stress to form the hip fine
Whatever the reason-can sometimes slip out in pregnancy and then the hip wont develop properly-the socket doesnt develop properly and femur doesnt go into it
Some risk factors-right hip (closer to spine of mother), ___, ___, also way to carry child
if not fully dislocated but loose -> early OA
What is Cams and Pincer impigement hips?
Applications of Wolff’s law
Cam impingement-growth of the neck of femur to form a bump (can be subtle)-usually result of exercise (stress -> bon growth)
Pincer impingement-unsure why, but growth of hip -> make the socket deeper
usually happens in young people that do a lot of exercise
What are the 3 groups of arthiritis patient?
Elderly-wear and tear
Injury-tore/broke something important and stayed loose
Young-impingement-usually exercise
How can Cams and Pincer impingement cause OA?
Cams-the bump, as you deep flex a lot can cause repeated damage to the laborum -> slowly damaged and pushed labrum -> hip joint damaged->OA
Pincer-> socket too deep so the bone hits it -> repeptitive trauma of the labrum (and also countre-coup)-both sides wear down
How can you try and repair Cams and Pincers impingement?
arthroscopy-> remove the bump or the pincer using a camera and a little bone drill
Should we then not to exercise to not get OA?
No-exercise is important because muscle keeps the bone strongs/and keeps the joints strong
Often people go in a loop of -pain during exercise->exercise less->do less and less->muscle waste
Exercise is the most effective treatment and management of OA -> surgery is mostly just a pain treatment
What helps keep the knee stable?
Synovial membrane around-with fluid (and fibrious membrane around that)
Cruciate ligament (ACL/DCL)
the C shaped cartilage that helps deepen the lips (meniscus)
Describe cartilage structure
Inital flat zone that there to allow for easy passing of one against another (superficial gliding zona)
Middle part are a bit more diagonal-need to resist some sidewards stress AND up/down straight (middle radial zone (60% of cartilage)
Then deep zone is purely veryical
Then tidemark-barrier between cartilage and calcified cartilage (bone)-no blood supply to the cartilage and so no infection can come in
ALL the nutrients pass via synovial fluid-> why cant repair
What is the role of the cruciate ligaments in OA? what are the ways to repair those ligaments
In Ruptures or damage-causes unstable knee -> displacement of the bones, weight bearing modified
-> will cause OA
Ligaments help with stability (especially when suddent movement), protecting cartilage, and stop knee from sliding
Can either surgical reconstruction
or massive amounts of exercise-keep muscles around very strong, but also have to wear a brace at all time
What is the role of meniscus tear in OA?
When gets damaged can cause pressure changes to your bone -> need surgery to cut the damaged part
If not can cause OA (and might need partial knee replacement)
