Osteoarthritis Flashcards
what is osteoarthritis?
a degenerative disease od joints that affects all of the weight bearing components of the joint eg bone, articular cartilage and menisci
what are some physical features of osteoarthritis?
-thickened capsule
-cyst formation and sclerosis in subchondral bone
-shelving fibrillated cartilage
-osteophytic lipping
-synovial hypertrophy
-altered contour of bone
what is the main tissue affected?
articular cartilage
what happens to the articular cartilage?
-increased swelling
-change in colour
-cartilage fibrillation
-cartilage erosion down to subchondral bone
what are the 3 types of cartilage?
-hyaline (articular)
-elastic (nose/ear)
-fibrocartilage (meniscus/pubic ramus)
what do chondrocytes (mesenchymal stem cells) do?
synthesise and maintain extracellular matrix
what Is the extracellular matrix?
(mainly collagen II) embedded in gel proteoglycans
hyaluronic acid chains with links containing chondroitin and keratin sulphate
protects chondrocytes from loading forces
definition of OA?
progressive disorder of the joints caused by gradual loss of cartilage resulting in the development of bony spurs and cysts at the margins of the joints
where does OA often occur?
fingers, hips, knees, thumbs, neck, lower back
what are some secondary causes?
-trauma
-hip dysplasia
-infection
-diabetes
what are some systematic risk factors?
-age
-genetics
-gender
-nutritional (low vit C and D)
what are some joint biomechanical risk factor?
-joint trauma
-obesity
-occupation
-abnormal joint biomechanics
-knee extensor weakness
-sports with joint risk
what are some key symptoms?
-pain when doing load bearing activities
-short lived stiffness in the morning generally
difficulty moving affected joints or doing certain activities
how can it be identified on an X ray?
-loss of joint space
-osteophytes
-subchondral sclerosis
-subchondral cyst
what is the possible treatments?
-meds (general pain killers)
-physio (muscle and tendon strengthening around affected joints)
-walking aids (transfer load to unaffected side)
-joint injections
-weight loss
what is cortisone/corticosteroid?
-joint injections which reduce inflammation response around joints
a viscous supplement that can replace synovial fluid in joints and increase viscosity and elasticity of fluid
what are some possible surgical treatments?
-athroscopy
-cartilage transplantation
-joint replacement
-bone realignment
what is arthroscopy?
joint replacement surgery?
-remove worn cartilage and replace with synthetic material
-key objective is pain relief and range of motion
-improves activities of daily living
cartilage transplant?
-osteo-articular transplant
-autologous chondrocyte implantation
-cadaver allografts
-osteotomy
