Cartilage injuries and arthritis Flashcards Preview

Year 2 > Cartilage injuries and arthritis > Flashcards

Flashcards in Cartilage injuries and arthritis Deck (31):
1

Where is hyaline cartilage found?

Covering the surface of bones at synovial joints

2

What are the functions of hyaline cartilage?

Decrease friction
Distribute load

3

Describe the structure of hyaline cartilage

Water
Collage type II
Proteoglycans
Chondrocytes

4

What do chondocytes do?

Produce collagen (type II), proteoglycans and enzymes which help maintain the extracellular matrix

5

How does hyaline cartilage receive it's nutrition?

Synovial fluid
Subchondral bone

6

What is the function of proteoglycans?

Highly hydrophilic molecules which "inflate like balloons" to provide compressive strength

7

What is the function of collagen?

Tensile strength

8

What are proteoglycans made of?

Hyaluronic acid

9

Hyaline cartilage defects can be traumatic or atraumatic. Give some examples of both

Traumatic
- Ligament injury
- Dislocation
Atraumatic
- Osteochondritis dissecans
- Osteoarthritis
- Inflammatory arthritis

10

Which type of cartilage injuries heal? What is different about healed cartilage as compared to normal cartilage?

Full thickness
Not hyaline but fibrocartilage which is less wear resistant with greater friction

11

What is osteochondritis dissecans?

Area of the knee loses its blood supply and cartilage +/- bone fragment detachment

12

In what age group is osteochondritis dissecans most common?

Adolescents

13

How is osteochondritis dissecans managed?

May heal/resolve spontaneously
Can pin in place if detaching on MRI
Can fix or remove if detached
Cartilage regeneration in severe cases

14

Is cartilage regeneration more effective on big or small defects?

Small

15

Which joint can cartilage regeneration techniques NOT be performed on? Why?

Patellofemoral joint
There is too much sheer stress at this joint for it to be effective

16

What are the techniques used for cartilage regeneration?

Drilling/microfracture
Mosaicoplasty
MACI
Osteochondral auto/allograft

17

What does MACI stand for?

Membrane induced autologous chondrocyte implantation

18

What are the contra-indications to cartilage regeneration?

Radiographic signs of osteoarthritis
Joint instability
Inflammatory arthritis

19

Why are open procedures not great with respect to cartilage regeneration?

Air is toxic to hyaline cartilage

20

What techniques of cartilage regeneration are used in tayside and why?

Microfracture - cheap and easy
Allograft - larger defects +/- bone damage

21

What is osteoarthritis?

Pathology of the joints resulting from imbalance of cartilage breakdown and regeneration

22

What predisposes to osteoarthritis?

Injury
Malalignment
Degenerate meniscal tear
Infection
Genetic

23

How is osteoarthritis initially managed?

Weight loss
Analgesia
Activity modification, aids, etc

24

When are steroid injections indicated in osteoarthritis?

Acute flare ups

25

What are the risks of steroid injection with respect to osteoarthritis?

Too many injections can accelerate OA
Infection risk

26

When is osteotomy indicated in osteoarthritis?

Early medial compartment OA in a varus leg

27

When is debridement and washout indicated in osteoarthritis?

Never because it doesn't work

28

Which compartment of the knee will be under the most stress in a varus and valgus knee respectively?

Varus - medial
Valgus - lateral

29

How can the directions of the legs in genu varum and valgus be remembered?

VaRum - feet Return
VaLgus - feet Leave

30

When is knee replacement indicated for osteoarthritis? Which type of knee replacement is most effective?

Elderly patients with end stage disease.
Total replacement has better results than partial replacement

31

What are the risks of knee replacement?

Deep infection
Stiffness
Pain
DVT +/- PE

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