Osteoarthritis Flashcards
OA affects women more than men (T/F)
T
___ of hip/knee replacements are for OA
95%
____ of people who have arthritis have OA
3/4
economic burden of OA is
2.9B
OA is the strongest determinant of ______
walking difficulty –> leads to risk for CV evets + diabetes
what is inflammatory arthritis defined by?
of leukocyes in affected joint tissues and synovial fluid
is cellular inflammation prominent in OA?
no; normally low leukocytes
where does pain in OA arise from?
muscles and ligaments around joint
OA is a purely degenerative disease
F; pathogenesis of OA includes biomechanical factors, proinflammatory mediators and proteases
pathogenesis of OA
altered joint loading (obesity, structural deformity, injury) or systemic factors (age, sex, genetics, proinflammatory cytokines from fat) –> matrix destruction/aberrant repair response/mechanical failure –> joint destruction
role of articular cartilage in joint
provide smooth, low-friction surface that allows for normal gliding motion of joint
role of subchondral bone, ligaments, meniscus and muscle
absorb load on join
role of hyaluronic acid
viscosity and with lubricin, protect joint surface
role of collagen fibers
provide tensile strength and restrain hydrophillic proteoglycans that provide resiliency
molecular pathogenesis of OA
degradation of proteoglycans by MMPs (MMP13 collagenase)
collagen structure altered
chondrocytes unable to repair
pathology of OA
fissuring of cartilage
increased thickening of bone (subchondral)
clinical presentation of OA
pain triggered by activity
morning stiffness < 30 min
activity makes pain worse, rest makes it better
describe PE for OA
heigh + weight - BMI stress pain on ROM swelling, redness knee alignment on standing joint laxity
what joints are involved in OA?
DIP joints PIP joints base of thumb neck lower back big toe hips knees
how to Dx OA?
adults aged 45+ diagnosed clinically if activity related joint pain + morning joint stiffness < 30 min
XR: weight bearing, AP and lateral knee
no MRI
what XR changes are seen on OA?
joint space narrowing
osteophyte formation
subchondral sclerosis
bone cysts
_____ is a primary modifiable factor for OA
obesity
non Rx management of OA
weight loss of 5% BW
physical activity
assistive devices (walking aids, shock absorbing shoes, knee brace)
what is GLA:D
education and exercise program for knee and hip OA
Rx management of OA
topical NSAIDs for hand/knee (diclofenac)
oral NSAIDs, COX2 inhibitors
acetaminophen (minimal effect)
duloxetine (SNRI)
opioids (tramadol); not recommended
intra-articular corticosteroid injection (short term)
PRP is indicated for OA pain relief
F
is stem cell transplant approved by Health Canada for treatment of OA?
no
indications for joint replacement surgery for OA
patient willingness
negative impact QOL
T/F?
OA is part of normal aging and nothing can be done
weight bearing activities make OA worse
F, F
is arthroscopic debridement and lavage indicated for OA?
no
