AFC Arthritis Flashcards

1
Q

Where do bones grow from?

A

Growth plate (epiphyseal plate)

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2
Q

State Hueter-Volkmann’s Law?

A

Increased compression at the growth plate slows down longitudinal growth
Increased tension at the growth plate speeds up longitudinal growth

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3
Q

Give an example of where this can be used to correct an abnormality.

A

Eight Growth Plate – if there is abnormal growth on one side of the distal tibial physis you can inset a metal plate with pins on either side of the growth plate to prevent further growth on that side and allow the other side to catch up

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4
Q

What are the three different types of knee alignment?

A

Normal/Neutral
Varus – bowed legs
Valgus – knocked knees

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5
Q

What types of athletes get varus alignment?

A

Footballers

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6
Q

Which part of the knee joint would be loaded most in varus alignment?

A

The inner part

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7
Q

What are the consequences of this?

A

It will wear out the cartilage and cause osteoarthritis

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8
Q

What surgical intervention can be performed before the onset of osteoarthritis to realign the knee joint?

A

Osteotomy – this involves taking a wedge out of the tibia to realign the knee joint

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9
Q

State Wolff’s Law.

A

Bone in a healthy person will adapt to the loads under which it is placed

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10
Q

Give an example that illustrates Wolff’s law.

A

Surfer’s knots

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11
Q

What are the two surfaces of the cortical bone?

A

Periosteal surface

Endosteal surface

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12
Q

Load on the bones causes an increase in cortical thickness – how is this response to loading different in children compared to adults?

A

Children – have an active periosteum and endosteum so they get increased bone growth at BOTH surfaces
Adults – their periosteum is less active – so the response to increased loading is mainly at the endosteal surface

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13
Q

A lot of problems to do with body shape occur in utero. Give an example of such a problem that is associated with 9-10% of cases of osteoarthritis

A

Developmental Dysplasia of the Hip (DDH)

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14
Q

Describe the appearance of the hip joint in someone who had DDH.

A

The hip joint may be higher than normal
The acetabulum is shallow and it doesn’t cover much of the femoral head
This leads to increased load and wear

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15
Q

Why is it important to spot these deformities early?

A

If these deformities are caught early, they could realign them and cause a remodelling of the joint to allow normal stance

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16
Q

Name and describe two abnormalities of the hip joint.

A

Cam – bump on the neck

Pincer – the acetabulum tries to capture the hip joint so it is much deeper than normal (mainly seen in females)

17
Q

What are the negative consequences of Cam abnormality?

A

Deep flexion will cause repeated impact between the bump on the femoral neck and the acetabular rim leading to the wearing away of thecartilage –> osteoarthritis

18
Q

What are the negative consequences of Pincer abnormality?

A

The femoral neck will impact with the deepened acetabular labrum and cause compacting of the femoral head posteriorly (this will cause a contre-coup type erosion of the cartilage on the posterior acetabular surface)

19
Q

Name the two cruciate ligaments of the knee joints and state their roles with regards to sliding at the knee joint.

A

Anterior cruciate ligament – stops the tibia from sliding forwards
Posterior cruciate ligament – stops the tibia from sliding backwards

20
Q

What is a synovial joint?

A

A joint covered with hyaline cartilage or fibrocartilage that is surrounded by a fibrous capsule with a synovial membrane on the inside producing synovial fluid to lubricate the joint

21
Q

What is the structural difference between the medial and lateral menisci?

A

The lateral meniscus has a much tighter C shape, medial is more cresent shaped

22
Q

What are the two main functions of cartilage?

A

Shock absorption

Low friction

23
Q

Which type of collagen is found in cartilage?

A

Type 2

24
Q

Describe the arrangement of collagen in the superficial layer andexplain why they are arranged like this.

A

Horizontally – resists shear forces

25
Q

Describe the arrangement of collagen in the deep layer and explain why they are arranged like this.

A

Vertically – resists compressive forces

26
Q

What provides the nutrition to the tissue above the tidemark?

A

Synovial fluid

27
Q

What is the downside to the lack of blood supply above the tidemark?

A

This means that if the cartilage superficial to the subchondral bone is damaged, it can’t really heal itself

28
Q

What is the name given to the pattern of fibres that form the collagen network in bone?

A

Arcades

29
Q

What happens to your tibia when the ACL snaps and what other structures will try to hold it in place?

A

It slides forwards
The meniscus will try to hold it in place
NOTE: if you don’t repair the ACL you will get meniscal tears because they are being strained in trying to keep the femur in place on the tibial plateau

30
Q

Describe the vascularity of the menisci.

A

Only the peripheral 1/3 has a blood supply