Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

LOCO2 > Treatment of OA > Flashcards

Treatment of OA Flashcards

1
Q

What is OA?

A
  • clinical syndrome of joint pain
  • accompanied by varying degrees of functional limitation
  • reduced quality of life
  • metabolically active repair processes causes localised loss of cartilage and remodelling of adjacent bone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What joints are most commonly affected in OA?

A
  • knee
  • hip
  • DIP and PIP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the symptoms and corresponding signs of OA?

A
  • joint pain on use -> bony enlargement at affected joints
  • morning stiffness vs. limited range of motion
  • joint instability vs. muscle atrophy/weakness
  • loss of function vs. malalignment/joint deformity
  • crepitus on motion is a symptoms and a sign
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the main non-pharmacological treatment methods?

A
  • exercise
  • transcutaneous electrical nerve stimulation
  • acupuncture
  • aids and devices
  • diet
  • nutraceuticals
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does exercise aim to do for OA?

A
  • local muscle strengthening
  • weight loss
  • general aerobic fitness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What do nutraceuticals involve?

A
  • increase intake of omega-3 rich foods

- chondroitin sulphate and glucosamine supplements are debated over (part of proteoglycans/hold water)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the main methods of pharmacological care for OA?

A
  • oral analgesics (paracetamol or topical NSAID)
  • if ineffective substitute with oral NSAIDs/COX2 inhibitor (use at lowest effective dose for shortest possible time)
  • intra-articular injections

(no disease modifying drugs on the market)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are intra-articular injections?

A
  • corticoid steroids
  • can last up to 6 months
  • painless
  • can further injury so dangerous
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When is the surgical management offered?

A
  • when pain stiffness and reduced function have a substantial impact on quality of life
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the surgical management options?

A
  • arthroscopic knee washout and debridement
  • arthroscopic knee washout and debridement and microfracture
  • Viscosupplementation
  • Chondrocyte Grafting
  • Mosiacplasty
  • Alteration of Joint Mechanics
  • Joint Replacement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is arthroscopic knee washout and debridement?

A
  • wash out = take synovial fluid out and replace with new artificial synovial fluid
  • debridement = cut and remove attached debris from cartilage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is arthroscopic knee washout and debridement + microfracture?

A
  • after wash out and debridement
  • drill into subchondral bone to red bone marrow which contains pluripotent stem cells which can repair articular cartilage
  • within 4-6 month repairs
  • best results if under 40 and not overweight
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is viscosupplementation?

A
  • injection of hyaluronic acid which is responsible for viscoelasticity of synovial fluid
  • direct analgesic effect
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the advantages of viscosupplementation?

A
  • works well at all stages of OA
  • improves patient assessed pain
  • well tolerated
  • LT effectiveness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the disadvantages of viscosupplementation?

A
  • severe OA may not respond as well

- some local adverse effects at injection site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is chondrocyte grafting?

A
  • uses periosteum from bone as a cap placed over defect
  • chondrocytes injected underneath periosteal path
  • over 1-6 months produce ECM and become integrated
  • decreases depth of articular cartilage
17
Q

What are the sources of chondrocytes for grafting?

A
  • rib costochondral process
  • non-damaged part of joint
  • cartilage implants from young individuals
  • often after microfracture which produces fibrocartilage and sometimes hyaline cartilage
18
Q

What is autologous chondrocyte implantation?

A
  • implantation of chondrocytes ensures cells become hyaline cartilage
19
Q

What is mosaicplasty?

A
  • osteochondral grafting
  • takes undamaged cartilage from less weight bearing region plus underlying bone
  • moves it to OA region
20
Q

What does alteration of joint mechanics involve?

A
  • osteotomy = cutting of bone and taking out a wedge, place mechanical instrument to realign joint
21
Q

What is genu valgus and varus?

A
  • osteotomy to femur

- osteotomy of tibia

22
Q

What are the types of joint replacement?

A
  • conventional hip replacement (large incision, cut muscles/ligaments/tendon to access joint)
  • newer minimally invasive (incision 10cm or less, less damage to surrounding structures)
23
Q

What are the complications of a cemented hip replacement prosthesis?

A
  • loosening and movement

- requires replacement

24
Q

What biologicals can be used for OA?

A
  • IL-1 blockage
  • TNF inhibition = adalimumab
    (low grade inflammation may be a problem and varies with time and cost)

LOCO2 (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions