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Clin Med IV - Ortho > Osteoarthritis > Flashcards

Osteoarthritis Flashcards

1
Q

Modifiable local risk factors of OA

A
  • Muscle strength (esp. quad. femoris)
  • Physical activity/occupation
  • Joint injury (esp. ACL tear)
  • Joint alignment
  • Leg length inequality
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2
Q

Many patients will show OA changes within ____ years after an ACL tear

A

10

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3
Q

Risk factors that increase chance of developing OA after ACL tear

A

Damage to:

  • Articular cartilage
  • Subchondral bone
  • Collateral ligaments
  • Menisci
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4
Q

________ is one of the strongest predictors of knee OA

A

Knee malalignment

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5
Q

Varus vs. valgus knee alignment in progression of knee OA

A

Varus → medial knee OA

Valgus → lateral knee OA

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6
Q

Modifiable systemic risk factors for OA

A
  • Obesity (esp. for knee/hip joints)
  • Diet
  • Bone metabolism
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7
Q

Non-modifiable risk factors of OA

A
  • Age
  • Female, esp. post-menopausal
  • Genetics
  • Ethnicity
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8
Q

Treatment for arthritis

A
  • Pain control
  • Viscosupplementation
  • PT, bracing, assistive devices
  • Surgery → arthroplasty or osteotomy
  • Risk factor modification → muscle strengthening, weight management
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9
Q

Definitive treatment for arthritis

A

Surgery - arthroplasty or osteotomy

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10
Q

1kg weight loss = ______ reduction in load during ADLs

A

4x

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11
Q

True or false: Opioids have little to no use in arthritis

A

True

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12
Q

First line analgesic for OA

A

Acetaminophen (Tylenol)

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13
Q

Maximum dosage of Tylenol

A

4g/day

2g/day if chronic alcohol intake or underlying liver disease

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14
Q

What options do you have if Tylenol isn’t treating OA pain?

A
  • NSAIDs
  • Viscosupplementation
  • Topical analgesics → diclofenac gel, capsaicin
  • Corticosteroid injections
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15
Q

True or false: NSAIDs work immediately

A

False

Analgesic effects begin within 1-2 hours, but anti-inflammatory effects may take 2-3 weeks

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16
Q

What counseling should you provide with NSAIDs?

A

GI complaints are common - take with food

17
Q

Maximum of ___ corticosteroid injections in a joint. Why?

A

3 injections/joint/year due to increased cartilage degeneration

18
Q

How do valgus braces help mediate pain relief?

A

Stabilize joint

Reduce muscle contractions and joint compressions

19
Q

What is hyaluronic acid used for in OA?

A

Synthesized by synovial membrane, functions as lubricant and shock absorber → viscosupplementation for OA

20
Q

Synvisc-One vs. Euflexxa

A
  • Synvisc has higher risk of pseudo-septic reaction (knee effusion, inflammation, leukocytosis)
  • Euflexxa better option b/c no pseudo-septic reaction
21
Q

When would you use narcotics in DJD?

A

Post-op, NOT pre-op

? Short-term use in exacerbations

Clin Med IV - Ortho (7 decks)

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