Different Kinds of Cartilige
Physeal: growth plates
Fibrocartilage: at tendon and ligament insertions into bone
Elastic: found in trachea
Articular/Hylan: cover ends of bone forming joints
Looks like a hardboiled egg. It is shiny, white, smooth, slippery with a very low coefficient of friction.
As the cartilage gets worn, striations are shown. Carilage ranges from grade 0 (healthy) to grade 4 (completely worn).
Depends on synovial fluid for nutrients.
Degenerative Joint Disease (DJD)
DJD is not the same as normal aging.
This is a failed attempt of the chondrocytes to repair damaged cartilage.
Degenerative or auto-immune
Can be caused by a LOT of things.
Radiographic Features of Arthritis
Joint space narrowing
Osteophytes (joint trying to expand SA)
Management of Joint Arthritis
1. Relaign = osteotomy (good for 15+ years)
2. Replace = joint replacement
3. Obliterate = fusion or excision (last choice)
What Else to Examine for Knee Pain
You should always examine the hips. Always check what is above and below the joint. Hip problems can often manifest as knee problems.
Used in the treatment of autoimmune diseases, such as arthritis.
Used as treatment for osteoarthritis.
May be useful in treating osteoarthritis.
Osteoarthritis of Hip - Range of Motion Loss
The first range of motion to lose with osteoarthritis of the hip is internal rotation.
Treatment of Avascular Necrosis
If possible, identify and remove the inciting cause.
Eventual joint replacement or fusion.
Also known as neuropathic arthropathy.
Progressive degeneration of a weight bearing joint. Classically presents as an unstable, painless, swollen joint.
Most common cause is diabetes in North America.