Osteoarthritis and Total Joint Atrhoplasty Flashcards
Osteoarthritis is a _____ joint disease that has a ____ onset
Degenerative; gradual
Describe what happens in osteoarthritis
Progressive deterioration of hyaline cartilage and underlying bone of joint
What parts of the body does osteoarthritis most commonly affect?
Knees, hips, hands
Which specific joints are most impacted with osteoarthritis?
Weight-bearing joints
Osteoarthritis typically begins after age ____; almost all adults affected by age ____
40; 80
Risk factors for osteoarthritis
Injury, abnormal motion, metabolic disorders, joint infection, obesity
Symptoms of osteoarthritis
Pain, joint stiffness, swelling, loss of function
Radiographic findings of osteoarthritis
Joint space narrowing, osteophytes, bony sclerosis
What two things can reduce symptoms of osteoarthritis?
Early diagnosis and treatment
Disadvantages of using NSAIDs chronically for Osteroarthritis
- Drug interactions
- Risk for adverse cardiac events
- Risk for GI ulceration and bleeding
What is the second most common cause of prosthetic joint failure?
Infections
What is the primary cause of prosthetic joint failure?
Aseptic loosening
Factors with Higher risk for prosthetic joint infection
- Prior joint surgery
- Failure to give antimicrobial prophylaxis during joint replacement surgery
- Immunosupression
- Perioperative wound complications
- High ASA score
- Prolonged operative time
- History of prosthetic joint infection
What is a risk factor for hematogenous prosthetic joint infection?
Bacteremia; especially Staphylococcus aureus
Tooth brushing and chewing can result in transient bacteremia in ___% of episodes
40%
Staph are _____ implicated in bacteremia following dental procedures
Rarely
What type of bacteria constitute the most of facultative oral flora?
Viridans-group Streptococci
What type of bacteria cause transient bacteremia after dental procedures that result in trauma to gingiva or oral mucosa?
Viridans-group Strep
Viridans-group Strep accounts for only __% of all hematogenous prosthetic joint infections.
2%
Cumulative exposure to transient bacteremia through daily activities is several times ____ than following a single exposure during a dental procedure.
Higher
Three examples of transient, low-grade bacteremia activities.
- Dental Procedures
- Tooth brushing
- Chewing
High risk and low risk dental procedures were not risk factors for joint infections in what subgroups?
- Immunocompromised
- Diabetics
- Had prior athroplasty
- Had duration of prosthetic joint infection symptoms of <8 days
- Were within a year of joint athroplasty
Which type of antibiotic do orthopedic surgeons prefer? why?
Cephalosporins rather than amoxicillin; because it enters the synovial fluid
In general, for patients with prosthetic joint implants, prophylactic antibiotics are ____ recommended prior to dental procedures to prevent PJI.
Not
