Osteoarthritis

Question 1

What is the #1 NON-MODIFIABLE Risk factor for OA?

Answer 1

AGE

Question 2

What is a modifiable systemic RF for OA

Answer 2

Obesity

Question 3

For every (     )unit increase in BMI, there is an assoc 
(    %) increase risk of knee OA

Answer 3

For every 5 unit increase in BMI, there is an assoc 35% increase risk of knee OA

Question 4

What is the STRONGEST PREDICTOR of likely disease progression

Answer 4

MISALIGNMENT

knee alignment is one of the strongest predictors of knee OA progression

Question 5

Modifiable local risk factors

Answer 5

Muscle strength
Physical activity/occupation
Joint injuries
Alignment

Question 6

Occupations requiring ( )2x risk of knee OA than those not requiring physical activity

Answer 6

Kneeling/squatting

Question 7

Does narcotics work for arthritis?

Answer 7

NO
minimal role in DJD
only short term use in exacerbation

Question 8

1st line drug therapy for pain mgmt DJD

Answer 8

ACETOMINOPHEN

good for mild-mod pain; add topical anagesic prn

Question 9

2nd line agent if acetominophen doesnt work?

Answer 9

NSAIDs

Caution: GI complaints most common ADR
-take w/ food

Question 10

Topical agents for arthritis

Answer 10

Diclofenac Gel (well tolerated)

Capsaicin

• can be used alone or in combo w/ other analgesics
• may take up to 2 wks to work

Question 11

How do braces provide pain relief?

Answer 11

By unloading the joint (increase joint separation)

Helps w/ misalignment

Question 12

How does Hyaluronic Acid help?

Answer 12

Found in synovial membrane and may have anti-inflammatory & antioxidative effect

Synvisc-One

Question 13

Surgeries for arthritis

Answer 13

Arthroplasty (total, partial)

Osteotomy

Question 14

Surgical indications

Answer 14

Failed med therapy
Pain persist
Limited physical function
Compromised quality of life