OA treatment Flashcards

1
Q

Most commonly effected joints in OA

A

Knees
Hips
Small hand joints

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2
Q

What causes OA

A

failed / reduced activity of repair processes causing cartilage loss and remodelling of adjacent bone

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3
Q

OA signs and symptoms

A

Joint pain
Morning stiffness <30mins
Joint instability or buckling
Loss of function
Crepitus on motion
Bony enlargements at joints
Limited range of motion
Muscle atrophy or weakness
Malalignment/joint deformity

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4
Q

OA lifestyle changes

A

Exercise
Weight loss
Suitable footwear
Walk at appropriate speed

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5
Q

Non pharma OA treatments

A

Exercise
Transcutaneous electrical nerve stimulation
Orthopaedic insoles
Walking stick
Anti inflam diet
Thermotherapy
Omega 3

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6
Q

OA Pharma treatment

A

Analgesia - paracetamol, NSAIDS, COX-2 inhibitor
IA Corticosteroid injections

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7
Q

What drug type is celecoxib

A

COX-2 inhibitor

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8
Q

Are COX-2 inhibitors types of NSAIDS

A

Yes

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9
Q

Why are PPIs given with NSAIDS

A

NSAIDs effect gastric mucosa

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10
Q

OA surgical treatments ents

A

Arthroscopic lavage
Arthroscopic lavage + debridement
Microfracture
Mosaicplasty
Chondrocyte graft
Osteotomy
Joint replacement

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11
Q

What type of joint can arthroscopy be performed on

A

Large joints

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12
Q

Arthroscopy

A

a minimally invasive surgical procedure on a joint in which an examination and sometimes treatment of damage is performed using an arthroscope

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13
Q

Arthroscopic knee washout and debridement

A

Knee washout - wash out synovial fluid and bits of cartilage in it
Debridement - remove and wash out frayed meniscus and cartalage

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14
Q

Microfracture

A

Drilling into subchondral bone and bone marrow pluripotent stem cells to stimulate articulate cartilage repair -> forms fibrocartilage

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15
Q

Does microfracture expose red or yellow bone marrow

A

Red

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16
Q

What substance is responsible for viscoelastic properties of synovial fluid

A

Hylauronic acid

17
Q

Viscosuplementation

A

Injecting hylauronic acid into joint, only available privately

18
Q

Viscosupplementation MOA

A

Returns higher molecular weight hyaluronans to increase viscosity of synovial fluid and provide direct analgesic effect

19
Q

Which cells can be grafted onto bare bone to repair cartilage defects

A

Chondrocytes

20
Q

Sources of chondrocytes for chondrocyte grafting

A

Rib chostochondral process
Non damaged part of joint

21
Q

What type of cartilage is formed as a result of microfracture

A

Fibrocartalage

22
Q

What type of cartilage forms as a result of chondrocyte grafting

A

Hyaline

23
Q

Mosaicplasty

A

Moving undamaged cartilage and underlying bone from less weight bearing regions and moving to OA region

24
Q

Osteotomy

A

surgical procedure that involves removing or adding bone to reshape or realign joints

25
Q

2 types of osteotomy

A

Closing - remove wedge of bone
Open - add bone/material

26
Q

Is the medial or lateral compartment of the knee more commonly effected by OA

A

Medial

27
Q

How long do joint replacements usually last

A

15-20 yrs

28
Q

Advantages of newer total hip replacement over conventional hip replacement

A

Smaller incision (<10cm vs 20-30cm)
Less damage to surrounding muscles, ligament, and tendons

29
Q

Biologicals for OA

A

IL1 blockage
TNF inhibition
Nerve growth factor

30
Q

Main Adverse effect of nerve growth factor in OA treatment

A

Rapid OA progression in other joints