Pathology - KOA & PFPS

Question 1

T/F: KOA involves the whole joint, including articular cartilage, bone, and soft tissues.

Answer 1

TRUE

Question 2

Osteophytes

Answer 2

Bone spurs

Question 3

Bony Sclerosis

Answer 3

Hardening of the bone

Question 4

Risk factors & causes of Primary KOA

Answer 4

Unkown!

Question 5

Risk factors of Secondary KOA (6)

Answer 5

Obesity
Previous trauma
Malalignment
Abnormal joint mechanics
Repetitive loading
Immobilization

Question 6

With a limb length discrepancy, which limb is OA more likely to occur?

Answer 6

longer

Question 7

Genu Varum leads to ____ compartment KOA

Answer 7

medial

Question 8

Genu Valgum leads to ____ compartment KOA

Answer 8

lateral

Question 9

What are the 2 types of KOA diagnoses?

Answer 9

Radiographic
Symptomatic

Question 10

KOA Grade 0

Answer 10

No presence of OA

Question 11

KOA Grade 1

Answer 11

Doubtful joint space narrowing

Question 12

KOA Grade 2

Answer 12

Possible joint space narrowing
Osteophyte formation (minimal)

Question 13

KOA Grade 3

Answer 13

Definite joint space narrowing
Osteophyte formation (moderate)

Question 14

KOA Grade 4

Answer 14

Severe joint space narrowing
Osteophyte formation (large)
Sclerosis

Question 15

Radiographic KOA is diagnosed at what grade?

Answer 15

2 or higher

Question 16

Symptomatic KOA diagnosis criteria

Answer 16

Knee pain AND 3 of the following:
Age >50
Stiffness <30min
Crepitus
Tenderness
Bony enlargement
No palpable warmth (more associated with RA)

Question 17

KOA common signs/symptoms

Answer 17

Pain (often medial)
Morning stiffness
Pain impacts sleep
Instability, buckling, giving way
Muscle weakness & contractures

Question 18

T/F: Since repetitive loading is a risk factor for KOA, we should avoid resistance training

Answer 18

FALSE - any exercise is helpful, as long as proper body mechanics

Question 19

T/F: KOA is reversible

Answer 19

FALSE - the disease itself is irreversible, BUT we can manage pain, function, and other symptoms

Question 20

PFPS Epidemiology

Answer 20

Difficult to identify cause, not a very specific condition.

Question 21

PFPS Diagnostic criteria (3)

Answer 21

1. Retropatellar or peripatellar pain.
2. Aggs = loading the joint in flexion (stairs, squat, prolonged sitting).
3. Rule out other conditions.

Question 22

PFPS Common symptoms

Answer 22

Pain - slow or rapid onset.
Muscle weakness.
Impaired flexibility.
Instability, buckling, giving way.
Crepitus.
Altered mechanics - tend to walk/stairs with lower knee flexion

Question 23

PFPS Prognosis

Answer 23

Recurrence is VERY common. Important to educate pt on self-managing symptoms