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Small Animal Surgery > Osteoarthritis > Flashcards

Osteoarthritis Flashcards

1
Q

Joints wear out over time due to what 4 factors?

A
  1. Trauma
  2. Disease
  3. Biochemical changes in articular cartilage
  4. Poor lubrication
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2
Q

Poor lubrication of a joint results in increased ___.

A

Friction

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3
Q

Lubrication is affected by what factors?

A
  1. Synovial membrane
  2. Physical and chemical properties of synovial fluid
  3. Load on the joint
  4. Type of joint movement
  5. Geometry of articular surfaces
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4
Q

What are the 2 functions of the synovium?

A
  1. Lubrication (adds glycosaminoglycans to synovial fluid & absorbs hyaluronan)
  2. Phagocytosis
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5
Q

Synovial fluid is a ___ of blood.

A

Dialysate

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6
Q

What are the 2 functions of synovial fluid?

A
  1. Lubrication

2. Nutrition to articular cartilage

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7
Q

What is the major glycosaminoglycan of synovial fluid?

A

Hyaluronic acid

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8
Q

True or False: Hyaluronic acid has a low molecular weight.

A

FALSE: High molecular weight

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9
Q

Hyaluronic acid provides ___ to the synovial fluid.

A

Viscosity

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10
Q

When hyaluronic acid is low in quality or quantity in the synovial fluid, what are you at risk of developing?

A

Osteoarthritis

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11
Q

True of False: Articular cartilage is avascular, without lymphatics, but is innervated.

A

FALSE: Articular cartilage is avascular, without lymphatics, but is NOT INNERVATED.

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12
Q

Chondrocytes get the majority (90-93%) of their nutrients from what?

A

Synovial fluid

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13
Q

How much of articular cartilage is made up of water?

A

70-80%

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14
Q

What are the 5 components of articular cartilage?

A
  1. Water (70-80%)
  2. Type II collagen fibrils
  3. Hyaluronic acid
  4. Chondrocytes
  5. Proteoglycan molecules
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15
Q

What is the most important type of lubrication for synovial fluid, weeping, boosted, or boundary?

A

Weeping

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16
Q

Proteoglycan depletion compromises ____.

A

Lubrication

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17
Q

Osteoarthritis is a _____ degeneration of articular cartilage.

A

Non-infectious

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18
Q

What are the 3 components of osteoarthritis?

A
  1. Non-infectious degeneration
  2. Periarticular fibrosis
  3. Osteophytes
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19
Q

What are the 5 signs of osteoarthritis?

A
  1. Exercise intolerance
  2. Shortened stride
  3. Lameness/bunny hop
  4. Behavior change/aggression
  5. Joint effusion
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20
Q

The majority of OA cases in dogs are due to primary or secondary causes?

A

Secondary

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21
Q

What is the first step of the vicious cycle of OA?

A

Poor lubrication

22
Q

What is the second step of the vicious cycle of OA?

A

Cartilage fibrillation

23
Q

What is the third step of the vicious cycle of OA?

A

Inflammatory mediator release

24
Q

What is the forth step of the vicious cycle of OA?

A

Depletion of matrix proteoglycans

25
Q

What is the fifth step of the vicious cycle of OA?

A

Damage to collagen fibril network (increase in MMPs and aggrecanase)

26
Q

What is the RESULT and final step of the vicious cycle of OA?

A

Cartilage degradation

27
Q

What are the 6 results of the vicious cycle of OA, including cartilage degradation?

A
  1. Cartilage loss (degradation)
  2. Periarticular fibrosis
  3. Synovitis
  4. Osteophyte formation
  5. Articular fibrillation
  6. Subchondral sclerosis
28
Q

What are the radiographic signs consistent with OA?

A
  1. Increased soft tissue opacity within the joint space (consistent with joint fluid)
  2. Periarticular new bone formation (osteophytes)
  3. Subchondral sclerosis
29
Q

True or False: Radiographic signs do not correlate with clinical function of an osteoarthritic patient.

A

TRUE

30
Q

True or False: There is no cure for OA.

A

TRUE - once it starts, it will progress

31
Q

What are the 3 keys to management of secondary OA?

A
  1. Treatment of the primary cause
  2. Decreasing the inflammatory response
  3. Maintaining cartilage health
32
Q

What are the 4 options for medical management of OA?

A
  1. Weight management
  2. Exercise moderation
  3. Chondroprotectives
  4. NSAIDs
33
Q

What are the 3 components of physical rehabilitation?

A
  1. Promote joint health through MOBILITY
  2. Maintain and improve MUSCLE MASS
  3. Prevent periarticular contraction
34
Q

Glucosamine is a precursor to ____.

A

GAGs

35
Q

Glycosamine stimulates the synthesis of what?

A

HA

36
Q

Chondroitin sulfate inhibits ___.

A

MMPs

37
Q

Chondroitin sulfate stimulates the synthesis of ____ and ____.

A

GAGs and collagen

38
Q

Which chrondroprotective is responsible for resiliency of cartilage?

A

Chondroitin sulfate

39
Q

Which two chondroprotectives are COX-independent anti-inflammatory?

A
  1. Glycosamine

2. MSM

40
Q

Which condroprotective has anabolic effects on cartilage?

A

Avacado/soybean unsaponifiables (ASU)

41
Q

Avacado/soybean unsaponifiables suppress the production of what?

A

MMP

42
Q

From what is the PSGAG Adequan obtained?

A

Brovine tracheal cartilage

43
Q

Adequan is a ____ injection twice weekly for up to 4 weeks.

A

Intramuscular

44
Q

What is the function of Adequan?

A

Slows cartilage degradation

45
Q

What type of injection is hyaluronan?

A

Intra-articular

46
Q

True or False: Hyaluronan stays in the joint for about 2-3 days.

A

FALSE: Hyaluronan leaves the joint completely within 24 hours.

47
Q

Hyaluronan has no effect on ___ progression or ____ in canine stifles.

A

Hyaluronan has no effect on OA progression or LOADING in the canine stifle.

48
Q

What are the 5 guidelines for NSAID use?

A
  1. Never use an NSAID and steroid together
  2. Check liver and kidney function prior to use
  3. D not use more than one NSAID at a time
  4. Use the lowest effective dose
  5. Run periodical bloodwork on chronic users
49
Q

What are the 2 reasons why cartilage generally heals poorly?

A
  1. Poor blood supply

2. Chrondrocytes do not multiply in the adult

50
Q

Micropicking can be used to encourage the formation of what?

A

Fibrocartilage

Small Animal Surgery (11 decks)

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