Joint Additives Flashcards
modes of administration for polyglycan
- IA
- IV (do NOT use- speeds up progression of OA)
Polyacrylamide hydrogels (PAAG)
synthetic hydrogel that remains in synovial structure for extended periods of time
4% Noltrex Vet
2.5% arthramid Vet
Adequan
a Polysulfated glycosaminoglucans (PSGAGs) that upregulates glycosaminoglycans and collagen synthesis and decreases inflammatory mediators
BUT can be immunosuppressive IA; therefore give with amikacin
this steroid has chondroprotective effects
triamcinolone acetonide
what is HA often combined with?
triamcinolone (steroid)
HA is a chondroprotectant and provides analgesia
TA is a chondroprotectant and provides anti-inflammatory effects
aggrecan
a type of proteoglycan that forms aggregates with HA -> protects collagens from damage
layers in synovial membrane (2)
- subintimal: blood supply + innervation
- intimal: synovocytes (macrophage type A and fibroblast type B)
Polysulfated glycosaminoglucans (PSGAGs): functions (3)
chondroprotectant that
- inhibits degradation enzymes
- counteracts IL-1
- reduces synovial effusion
where does the HA come from? what is it and what does it do?
Type B synoviocytes (fibroblasts)
it’s a chondroprotectant
it’s a long unbranched non-sulfated GAG that provides viscoelasticity, lubrication, scavenges free radicals, increases endogenous production of HA, and decreases degradation of aggrecan
***ALSO provides analgesia IA
examples of biologics (5)
- platelet rich plasma
- IRAP (interluekin-1 receptor antagonism protein)
- pro-stride
- stem cells
- pulpcyte (mix of allogenic stem cells and cartilaginous matrix components)
articular cartilage is comprised of…(4)
- 80% water
- Proteoglycans
- HA
- collagens
PSGAGs should never be used with what?
steroids!! because it has its own immunosuppressive effect
effects of triamcinolone
steroid that is a chondroprotectant and provides anti-inflammatory effects
true or false: OA can be present without rad signs
true
one of the first visible signs of joint degeneration
cartilage fibrillation
hyaluronic acid
backbone of the catilaginous matrix;
proteoglycans (like aggrecan) bind HA filaments via protein links to create a polarized charge, which provides a sponge like shock absorbing effect
function of articular cartilage?
- creates joint surface
- special extracellular matrix that distributes compressive loads
often used post surgical to replace synovial fluid
polyglycan
HA + chondroitin sulfate + N-acetyle-D-glucosamine
***do NOT give IV (increases progression of OA)
polyglycan: what is it? what is it used for?
HA + chondroitin sulfate + N-acetyle-D-glucosamine
often used post surgical to replace synovial fluid
***do NOT give IV (increases progression of OA)
recommended protocol for IA injections of HA?
20 mg once weekly for 3 weeks
enthesiophyte formation occurs where?
soft tissue attachments
types of synovocytes? what layer of the synovial membrane are they in?
both are in the intimal layer
- Type A: macrophages
- Type B: fibroblasts (produce HA, aggrecan, collagen, cytokins, eicosanoids, proteases)
administration of Polysulfated glycosaminoglucans (PSGAGs)
- IA
- IM
BUT studies suggest decreases PGE-2 better when given IA
what’s used to define the health of a joint?
articular cartilage
