OA treatment

Question 1

Most commonly effected joints in OA

Answer 1

Knees
Hips
Small hand joints

Question 2

What causes OA

Answer 2

failed / reduced activity of repair processes causing cartilage loss and remodelling of adjacent bone

Question 3

OA signs and symptoms

Answer 3

Joint pain
Morning stiffness <30mins
Joint instability or buckling
Loss of function
Crepitus on motion
Bony enlargements at joints
Limited range of motion
Muscle atrophy or weakness
Malalignment/joint deformity

Question 4

OA lifestyle changes

Answer 4

Exercise
Weight loss
Suitable footwear
Walk at appropriate speed

Question 5

Non pharma OA treatments

Answer 5

Exercise
Transcutaneous electrical nerve stimulation
Orthopaedic insoles
Walking stick
Anti inflam diet
Thermotherapy
Omega 3

Question 6

OA Pharma treatment

Answer 6

Analgesia - paracetamol, NSAIDS, COX-2 inhibitor
IA Corticosteroid injections

Question 7

What drug type is celecoxib

Answer 7

COX-2 inhibitor

Question 8

Are COX-2 inhibitors types of NSAIDS

Answer 8

Yes

Question 9

Why are PPIs given with NSAIDS

Answer 9

NSAIDs effect gastric mucosa

Question 10

OA surgical treatments ents

Answer 10

Arthroscopic lavage
Arthroscopic lavage + debridement
Microfracture
Mosaicplasty
Chondrocyte graft
Osteotomy
Joint replacement

Question 11

What type of joint can arthroscopy be performed on

Answer 11

Large joints

Question 12

Arthroscopy

Answer 12

a minimally invasive surgical procedure on a joint in which an examination and sometimes treatment of damage is performed using an arthroscope

Question 13

Arthroscopic knee washout and debridement

Answer 13

Knee washout - wash out synovial fluid and bits of cartilage in it
Debridement - remove and wash out frayed meniscus and cartalage

Question 14

Microfracture

Answer 14

Drilling into subchondral bone and bone marrow pluripotent stem cells to stimulate articulate cartilage repair -> forms fibrocartilage

Question 15

Does microfracture expose red or yellow bone marrow

Answer 15

Red

Question 16

What substance is responsible for viscoelastic properties of synovial fluid

Answer 16

Hylauronic acid

Question 17

Viscosuplementation

Answer 17

Injecting hylauronic acid into joint, only available privately

Question 18

Viscosupplementation MOA

Answer 18

Returns higher molecular weight hyaluronans to increase viscosity of synovial fluid and provide direct analgesic effect

Question 19

Which cells can be grafted onto bare bone to repair cartilage defects

Answer 19

Chondrocytes

Question 20

Sources of chondrocytes for chondrocyte grafting

Answer 20

Rib chostochondral process
Non damaged part of joint

Question 21

What type of cartilage is formed as a result of microfracture

Answer 21

Fibrocartalage

Question 22

What type of cartilage forms as a result of chondrocyte grafting

Answer 22

Hyaline

Question 23

Mosaicplasty

Answer 23

Moving undamaged cartilage and underlying bone from less weight bearing regions and moving to OA region

Question 24

Osteotomy

Answer 24

surgical procedure that involves removing or adding bone to reshape or realign joints

Question 25

2 types of osteotomy

Answer 25

Closing - remove wedge of bone Open - add bone/material

Question 26

Is the medial or lateral compartment of the knee more commonly effected by OA

Answer 26

Medial

Question 27

How long do joint replacements usually last

Answer 27

15-20 yrs

Question 28

Advantages of newer total hip replacement over conventional hip replacement

Answer 28

Smaller incision (<10cm vs 20-30cm) Less damage to surrounding muscles, ligament, and tendons

Question 29

Biologicals for OA

Answer 29

IL1 blockage TNF inhibition Nerve growth factor

Question 30

Main Adverse effect of nerve growth factor in OA treatment

Answer 30

Rapid OA progression in other joints