Osteoarthritis Flashcards
what is OA?
where joints become stiff and painful
what is the most common type of arthritis?
OA
what are the symptoms of OA?
pain, swelling at the joint, limited mobility
what is the aetiology of OA?
was regarded as wear and tear more recently regarded as degradation of cartilage and remodelling of of bone at joints due to active response from chondrocytes
what are osteophytes?
they are tiny bone spurs - little bone growths forming at joints
what is synovial fibrosis?
disturbance to the balance of degradation and proliferation of cells and results in excessive cartilage within the ECM
what are RF for OA?
fam history, age, obesity, female
why are the symptoms hard to diagnose?
As they are similar and non specific so doctors need to create a differential diagnosis
what are the conservative treatment approaches?
exercise, footwear, education, physio
what are the pharmacological approaches to treatment of OA?
- analgesics - acetaminophen, opioids
- NSAIDs - oral and topical
hyaluronic acid
what does pharmacological approaches do in OA?
mainly treats symptoms only
what are the benefits of topical NSAIDs?
direct local application and avoids GI issues
what should NSAIDs be taken with?
proton pump inhibitors eg lansoprozole
what are the surgical interventions in OA?
- glucocortoid injection directly in joint
2. arthroplasty - total or partial
what occurs during a full arthroplasty?
cartilage replaced by artificial endoprosthesis
what does PHE recommended for healthy PA which is preventive for OA?
- 10,000 steps a day
- or 150mins moderate exercise weekly
- or 75 mins vigorous exercise weekly
what group is researching in NCL for OA?
skeletal research group
what is the skeletal research group looking at?
- looking at bio and biochem of cartilage including wnt pathways
- genetics, epigenetics, genomics
- analysing clinical studies
how does wnt signalling pathway relate to OA?
wnt/ beta- carenin classical pathway is overactive within OA
in 2017, how many are globally affected by OA?
303 million
how many people suffer with knee OA (2017)?
263 million
how many people suffer with hip OA (2017)
40 million
what percentage of the UK pop over 45 are affected by OA?
30%
how much does OA and RA cost the NHS annually?
£10.2 billion
how does polypharmacy relate to OA?
NSAIDs require PPI, can not prolong use of NSAIDS because it causes kidney, liver, GI issues
what is the issue with polypharmacy and hospital admission?
1 out of 5 hospital admissions are drug related and preventable
how does care homes contribute to the huge number of drug related admissions to hospital?
70% of the drug admissions are due to care home medicine errors
what is synovitis (2021)?
typical chronic aseptic inflammation usually occurs in early stages of OA
what inflammatory markers are involved in synovitis? (2021)
TNF, Il-1beta, ILI6, IL-I8
how is the synovitis seen and measured?
using ultrasound - doppler electrical signals can see the inflammation
as well as inflammatory markers what else does synovitis produce (2021)?
they produce pain via physiological mediators eg bradykinin and angiogenesis
what does angiogenesis do in synovitis?
increases inflammation and then synovial fibrosis which makes more inflam
how often is a partial arthroplasty done? (NHS)
every 10 yrs
what age group is a partial arthroplasty usually performed on? (NHS)
55-64 years
how long is recovery for partial arthroplasty? (NHS)
6 months use of walking aids and 2 years for scars to fully heal
what age group is a full knee arthroplasty usually performed on? (NHS)
60-80
what is the difference between total and full arthroplasty?
both sides of the joint are replaced and takes longer for hospital and home recovery
why is hyaluronic acid beneficial in OA treatment?
can be administered as injection into joint, it can restore lubrication and induce proliferation of new cell regeneration
where does the information relating to arthroplasty originate from? eg how long does partial anthroplasty last
NHS
What year is the synovitis study from?
2021
why is the overactivity of beta/ catenin bad in OA?
leads to cellular adhesion
what does hyaluronic acid do?
acts as a cushion/ lubricant in the joints and tissues
what does collagenase do?
degrades collagen
what do ADAMTS degrade?
proteoglycans
what is the consequence of cartilage and proteoglycans being degraded?
destroys articular cartilage at joints, exposes subchondral bone and the remodelling causes osteophytes and the joint space is reduced
