Cartilage

Question 1

the collagen that comprises hyaline cartilage is predominantly what type?

Answer 1

type II

Question 2

how are chondrocytes nourished, since articular cartilage is avascular?

Answer 2

diffusion from synovial fluid

Question 3

which type of cartilage primarily composes the insertions of tendons/ligaments?

Answer 3

fibrocartilage

Question 4

what is the type of collagen that is present in fibrocartilage?

Answer 4

type 1

Question 5

menisci are made of what type of cartilage?

Answer 5

type 1

Question 6

healing of articular cartilage injuries is enhanced by what?

Answer 6

motion

Question 7

in a deep articular cartilage lesion, what type of cartilage is involved in the healing response?

Answer 7

type 1 collagen- fibrocartilage

Question 8

what is the anatomical term for a cartilage outgrowth adjacent to a physis where tendons and ligaments attach?

Answer 8

apophysis

Question 9

on a t2 weighted image, fibrocartilage is what general color?

Answer 9

dark

Question 10

on a t2 weighted MRI image, hyaline cartilage is generally what color?

Answer 10

gray

Question 11

FAI can cause injury to what two structures of the hip joint?

Answer 11

labrum or articular cartilage

Question 12

what is the most common subtype of FAI?

Answer 12

mixed

Question 13

what is the most common apophysitis of the hip?

Answer 13

ischial tuberosity apophysitis

Question 14

why is the proximal tibial articular surface less prone to cartilage injury?

Answer 14

overlying meniscus provides protection

Question 15

what type of non surgical management is appropriate for focal chondral defect of the knee (3 options?)

Answer 15

1. hyaluronic acid injection
2. steroid injection
3. physical therapy

Question 16

in what surgical treatment option for focal chondral defect of the knee does cartilage get grafted from a non essential bone, cultured, and reimplanted?

Answer 16

autologous chondrocyte implantation

Question 17

in autologous chondrocyte implantation, what type of cells make it possible for chondrocytes to proliferate once reimplanted?

Answer 17

pluripotent MSCs

Question 18

in what procedure to treat focal chondral defect of the knee is the result that reimplanted chondrocytes produce hyaline cartilage?

Answer 18

ACI

Question 19

what is an advantage of osteochondral allograft transplantation over osteochondral autograft transfer?

Answer 19

allograft transplantation allows replacement of viable hyaline cartilage

Question 20

explain the difference between osteochondral autograft transfer and autologous chondrocyte implantation?

Answer 20

OAT - transfer of patient normal sites of osteochondral tissue, bony healing occurs with fibrous tissue
ACI - patient’s chondrocytes are harvested, cultured, and then reimplanted to produce hyaline like cartilage

Question 21

what is the typical return to sport time for osteochondral autograft transfer and autologous chondrocyte implantation?

Answer 21

3-6 months

Question 22

which cartilage injury is characterized by separation of subchondral bone and overlying articular cartilage?

Answer 22

osteochondritis dessicans

Question 23

what is the typical location of osteochondritis dessicans?

Answer 23

lateral portion of the medial femoral condyle of the knee

Question 24

osteochondritis dessicans most often occurs in what age group?

Answer 24

10-15 years old

Question 25

how is a stable osteochondritis dessicans lesion treated in an adolescent?

Answer 25

restricted weight bearing

Question 26

t/f prognosis for osteochondritis dessicans is best for patients with open physes

Answer 26

true

Question 27

if surgery is performed for osteochondritis dessicans, what is the typical time for return to play?

Answer 27

3-6 months

Question 28

name two osteochondroses that occur at traction apophyses of the knees in the skeletally immature

Answer 28

Osgood-Schlatter and Sinding-Larsen-Johansson syndrome

Question 29

what type of knee strap can be used in the treatment for osgood-schlatter and sinding-larsen-johansson syndrome?

Answer 29

cho-pat strap

Question 30

what cartilage defect of the ankle is more likely with a history of ankle inversion injury with recurrent lateral ankle instability?

Answer 30

osteochondral lesion of the talus

Question 31

how is an osteochondral lesion of the talus treated in a skeletally immature patient?

Answer 31

observation with immobilization

Question 32

what is the name for osteochondrosis of the achilles tendon insertion to the calcaneus?

Answer 32

Sever's disease

Question 33

an XR shows sclerosis and flattening of the navicular. what is the most likely diagnosis?

Answer 33

Kohlers disease (osteonecrosis of the tarsal navicular)

Question 34

what is Freiberg infarction?

Answer 34

osteochondrosis of the second metatarsal head

Question 35

t/f most patients with Freiberg infarction have a good prognosis with conservative management

Answer 35

true

Question 36

what is the treatment for Kohlers disease?

Answer 36

activity modification and immobilization

Question 37

t/f kohlers disease is a self limiting condition that often takes 6-8 weeks to return to play

Answer 37

true

Question 38

osteochondritis dessicans of the elbow typically involves what bone?

Answer 38

capitellum of the dominant hand

Question 39

in the case of osteochondritis dessicans of the elbow, what physical exam maneuver should be performed to rule out elbow instability?

Answer 39

posterolateral rotary instability test

Question 40

what condition is avascular osteochondrosis of the capitellum in young children?

Answer 40

Panner disease

Question 41

t/f Panner disease is a self limiting condition

Answer 41

true

Question 42

what is the likely MOI of Panner disease:

Answer 42

lateral compression overuse injury

Question 43

what type of ulnar variance is a risk factor for Kienbock disease

Answer 43

negative ulnar variance

Question 44

what is the initial management for Kienbock disease?

Answer 44

activity modification and immobilization