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LOCO 2 > Osteoathritis > Flashcards

Osteoathritis Flashcards

1
Q

Name some risk factors for osteoathritis

A 
Genetics
Age
Mechanical injury
Gender
Joint immobilisation
Obesity
Overuse
High intensity sport
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2
Q

Briefly state what happens to bone and cartilage as a result of osteoathritis

A

Loss of cartilage

Remodelling of adjacent bone

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3
Q

5 symptoms of OA

A 
Joint pain with use
Morning stiffness lasting <30 minutes
Joint instability or buckling
Loss of function
Crepitus on motion
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4
Q

5 signs of OA

A 
Bony enlargements at joints
Limited range of motion
Muscle atrophy
Malalignment
Crepitus
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5
Q

Give some examples of non pharmacological care

A 
Exercises
TENS
Acupuncture
Aids and devices
Diet
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6
Q

What are the aims of exercising with OA

A

Local muscle strengthening
General aerobic fitness
Weight loss

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7
Q

What aids and devices may somebody with OA use

A

Orthopaedic insoles

Walking stick

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8
Q

What netriceuticals may be prescribed

A

Increase intake of omega-3 rich foods

Chondroitin sulphate and glucosamine supplements

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9
Q

What drugs are first line for osteoathritis

A

Paracetemol/ topical NSAID

Topical capsaicin

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10
Q

What drugs may be offered where paracetamol/ topical NSAIDs are ineffective

A

Oral NSAID/ COX-2 inhibitor

Intra-articular corticosteroid injections

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11
Q

What COX-2 inhibitor is commonly used to treat osteoathritis

A

Celecobix

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12
Q

When is surgical management suggested for osteoathritis

A

Pain stiffness and reduced function have significant impact on quality of life
Waking up at night due to the pain

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13
Q

What is an arthroscopic lavage plus debridement

A

Washout of the knee under general anaesthetic

Debridement involves using instruments to remove damaged cartilage or bone

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14
Q

What is a microfracture

A

Drilling into subcondral bone and bone marrow stem cells to stimulate repair of articular cartilage

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15
Q

How much of a difference does debridement make?

A

80-90% of patients who had debridement and washout were pain free at a year
14% of those with just wash out were pain free

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16
Q

How long does it take for cartilage to recover

A

4-6 months

17
Q

What molecule is responsible for the viscoelastic properties of synovial fluid

A

Hyaluronic acid

18
Q

What is viscosuplementation

A

Addition of hyaluronic acid via injection

19
Q

Advantages of Viscosuplementation

A
  • Works well at all stages
  • Improves pain
  • Well tolerated
  • Long term effectiveness
20
Q

Disadvantages of viscosuplementation

A
  • Severe OA may not respond well

- Some local adverse effects

21
Q

Describe the mechanism by which Viscosuplementation works

A
  • Returns high molecular weight hyaluronans and increases viscocity
  • Provides direct analgesic effect
22
Q

What is chondrocyte grafting

A

Grafting of autologous chondrocytes to repair larger defects

23
Q

Where can chondrocytes be found for the graft

A

Rib costochondral process

Non damaged part of the joint

24
Q

What is created in microfracture

A

Fibrocartilage

25
Q

Disadvantages of microfracture

A

Less durable and resilient

26
Q

What is formed in autologous chondrocyte implantation

A

Hyaline like cartilage

27
Q

What are the disadvantages of autologous chondrocyte implantation

A

Hypertrophy

Unreliable biological potential of implanted cells

28
Q

What is mosaicplasty

A

Undamaged cartilage taken from less weight bearing regions plus underlying bone and move to OA region

29
Q

How can osteotomy be used to treat osteoathritis

A

Medial compartment usually affectedd

By taking a wedge from the side of the tibia you can realign the joint surfaces

30
Q

What osteotomy should be done if genu valgus

A

Osteotomy to femur

31
Q

What osteotomy should be done if genu varus

A

Osteotomy to tibia

32
Q

Name some potential biologicals for OA treatment

A

IL1 blockage

TNF inhibition

33
Q

Give an example of a drug that inhibits TNH

A

Adalimumab

LOCO 2 (25 decks)

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