Unit 2: 2 - Osteoarthritis Flashcards
What is a diarthrodial joint?
Joint where 2 bones come together
What does poor joint lubrication result in?
Increased friction
What is synovial fluid?
A dialysate of blood
What are 2 functions of synovial fluid?
- Lubrication
- Nutrition to the articular cartilage
What is the chief glycosaminoglycan (GAG)?
Hyaluronic acid (HA)
What are 3 features of HA?
- High molecular weight
- Prevents dilution
- Provides viscosity
What can occur if HA is low in quality and quantity?
Osteoarthritis
How much of articular cartilage is made up of water?
70-80%
What is the green arrow pointing to?
Hyaluronic acid backbone of articular cartilage
What is contained in the blue oval?
Proteoglycan complex
OA is aberrant _____ and _____ of articular cartilage.
repair, degradation
OA consists of bone formation called _____ at the _____ margins.
osteophytosis, synovial
OA results in ___articular fibrosis.
peri
The vast majority of OA in dogs is _____ OA.
secondary
T/F: There is NO cure for OA
True
What happens once OA starts?
it will progress
Do radiographic signs for OA correlate with clinical function?
No
What should you treat with secondary OA?
The primary cause
What should be decreased when there is secodary OA?
The inflammatory response
What should we do regarding cartilage in secondary OA?
Maintain cartilage health
What are 4 ways to medically manage OA?
- Weight management
- Exercise moderation
- Chondroprotectives
- Pain management
What are 2 things that we can do to moderate exercise in a pet with OA?
- Controlled exercise
- Low-impact (leash-walking, swimming)
What are 6 chondroprotectives we can use in OA?
- Glucosamine
- Chondroitin sulfate
- Manganese ascorbate
- Avocado/soybean unsaponifiables (ASU)
- MSM
- Omega 3 fatty acids
How long should chondroprotectives be given?
Give for 6 weeks and continue if working
Glucosamine is a precursor to _____.
GAGs (HA)
What role does glucosamine have?
- Formation and repair of cartilage
- Free O2 radical scavenger
- Anti-inflammatory (weak)
- Stimulates HA synthesis
What are the 3 functions of chondroitin sulfate?
- Inhibits MMPs
- Stimulates GAGs and collagen synthesis
- Responsible to resiliency of cartilage
What is adequan made from?
bovine tracheal cartilage
How is adequan used and what does it do?
IM injection 2x/week for up to 4 weeks;
Slows cartilage degradation
What is hyaluronan used for?
Intraarticular injection that is used more for large animals
What is the most common side effect of NSAIDs?
GI upset
You should NEVER use NSAIDs with _____.
steroids
Before using NSAIDs, you should check for _____ or _____ disease.
liver, kidney
How many NSAIDs can be used at one time?
1
How many days should the wash-out be between NSAIDs?
4-7 days
How many days should the wash-out be for aspirin and why?
7-10 days;
It binds platelets and 7-10 days is the lifespan of a platelet
What dose should be used with an NSAID?
Lowes effective dose
What is the goal for NSAID use?
To wean patient off NSAIDs with use of other medical management modalities (need to periodically check bloodwork on chronic NSAID users)
What does micropicking cartilage allow for?
Blood flow from subchondral bed and encourages fibrocartilage formation
What are the 2 types of inflammatory OA?
Erosive (rheumatoid) vs. non-erosive
What type of OA is involved typically with multiple joints?
Nonerosive Immune-Mediated Polyarthritis (IMPA)
What type of arthritis has the least total cell count? The most?
Least = OA (2-5)
Most = infective arthritis (40-267)
What type of arthritis has the highest % of mononuclear cells? The least?
Highest = OA (88-100%)
Lowest = Infective (1-10%)
What type of arthritis has the lowest % of NPs? Highest?
Lowest = OA (0-12%)
Highest = Infective (90-100%)
