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MSK Unit 2 > Osteoarthritis Lecture - Week 6 > Flashcards

Osteoarthritis Lecture - Week 6 Flashcards

1
Q

What joints are most commonly affected?

A
  • Knees
  • Hips
  • Hands
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2
Q

What fails with osteoarthritis?

A
  • Articular cartilage failure with secondary components of inflammation
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3
Q

What factors can cause osteoarthritis?

A
  • Genetics
  • Metabolic
  • Biochemcial
  • Biomechanical
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4
Q

Pathology and disease process of OA

A
  • Chondrocytes fail to repair damaged articular cartilage —> unstable matrix
  • Progressive cartilage loss, penetrating to subchondral bone —> inflammatory response
  • Macrochanges
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5
Q

What is a type III chondral injury considered?

A

Full thickness

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6
Q

Macro changes of OA

A
  • Progressive cartilage loss
  • Subchondral bone reaction/remodeling (sclerosis)
  • Osteophyte formation
  • Synovial inflammation
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7
Q

What happens with chondrocytes during OA?

A
  • Chondrocytes are injured, metabolism decreases which leads to decreased proteoglycans
  • Increased proteases that increase chondrocyte death, decreased ECM production
  • Decreased water content - cartilage becomes stiff and brittle
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8
Q

What are the types of OA?

A
  • Primary (idiopathic)
  • Secondary
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9
Q

Primary (idiopathic)

A
  • Localized or generalized forms
  • Localized OA most commonly affects one joint (hands, hips, spine, knees, feet)
  • Generalized OA - three or more joint sites
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10
Q

Secondary OA

A
  • Post traumatic
  • Congenital or developmental disorders
  • Calcium pyrophosphate dihydrate deposition disease (CPPD)
  • Other bone and joint disorder
  • Other diseases
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11
Q

Etiology of OA - multi factorial

A
  • Aging
  • Obesity
  • Joint injury: trauma or repetitive microtrauma
  • Chronic low grade joint inflammation
  • Heredity/genetics
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12
Q

What are the commonly affected joints of OA?

A
  • Cervical and lumbar spine
  • Hand: 1st CMC, PIPs, DIPs
  • Hip
  • Knee
  • Foot: 1st MTP, subtalar joint
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13
Q

Risk factors of OA

A
  • Age (50+)
  • Sex (male <45, female >45)
  • Family history
  • Occupation
  • Past injuries, congenital/developmental conditions
  • Obesity (loss of mobility exacerbates this)
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14
Q

Physical examination clinical signs of OA

A
  • Crepitus
  • Bony enlargement
  • Decreased ROM
  • Malalignment or deformity
  • TTP
  • Mild, localized joint effusion
  • Impaired muscle performance, balance, gait and transfers
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15
Q

Clinical symptoms of OA

A
  • Local joint disease
  • Unilateral/asymmetrical
  • More common as older
  • Morning pain/stiffness <30 min
  • No constitutional symptoms
  • Hand joints
  • X rays
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16
Q

X ray evaluation of OA

A
  • Reduced joint space
  • Osteophyte formation
  • Subchondral sclerosis
  • Subchondral cysts
17
Q

Clinical Symptoms of RA

A
  • Systemic autoimmune
  • Symmetrical
  • Can occur at any age
  • Morning pain/stiffness >30 min
  • Constitutional symptoms
  • Small joints of hand
18
Q

OA Management

A
  • Pharmacological approaches (oral, topical, intraarticular)
  • Physical, psychosocial and mind-body approaches
  • Surgical
19
Q

Self - efficacy and self- management of OA

A
  • Understand condition
  • Stress reduction and coping strategies
  • Addressing insomnia
  • Enhance fitness level
20
Q

Weight loss management for OA

A

> 5% weight loss clinical changes -
- Increased efficacy with exercise program

21
Q

Joint protection and energy conservation strategies for OA

A
  • Monitor activities and stop when discomfort or fatigue develops
  • Alternative activities, balance work and rest
  • Maintain ROM and strength
  • Avoid deforming positions
  • Use stronger and larger muscles when possible
22
Q

Braces and Assistive devices for OA

A
  • When ambulation or joint stability is significantly impacted
  • Cane (strong)
  • Tibiofemoral brace for unloading (strong)
  • Patella (conditional)
23
Q

Hand assistive devices/brace for OA

A
  • Orthosis for 1st CMC (strong)
  • Other fingers (conditional)
24
Q

What other adaptive equipment for OA

A
  • Raise commode
  • Grab bars
  • Shower chairs
25
Q

Exercise for OA

A
  • Mobility - ROM and stretching
  • Strengthening - resistance training
  • Neuromuscular balance training
  • Aerobic conditioning
  • Aquatic exercise
  • Tai Chi

MSK Unit 2 (12 decks)

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