Osteoarthritis Flashcards Preview

Clin Med IV - Ortho > Osteoarthritis > Flashcards

Flashcards in Osteoarthritis Deck (21):
1

Modifiable local risk factors of OA

- Muscle strength (esp. quad. femoris)
- Physical activity/occupation
- Joint injury (esp. ACL tear)
- Joint alignment
- Leg length inequality

2

Many patients will show OA changes within ____ years after an ACL tear

10

3

Risk factors that increase chance of developing OA after ACL tear

Damage to:
- Articular cartilage
- Subchondral bone
- Collateral ligaments
- Menisci

4

________ is one of the strongest predictors of knee OA

Knee malalignment

5

Varus vs. valgus knee alignment in progression of knee OA

Varus → medial knee OA
Valgus → lateral knee OA

6

Modifiable systemic risk factors for OA

- Obesity (esp. for knee/hip joints)
- Diet
- Bone metabolism

7

Non-modifiable risk factors of OA

- Age
- Female, esp. post-menopausal
- Genetics
- Ethnicity

8

Treatment for arthritis

- Pain control
- Viscosupplementation
- PT, bracing, assistive devices
- Surgery → arthroplasty or osteotomy
- Risk factor modification → muscle strengthening, weight management

9

Definitive treatment for arthritis

Surgery - arthroplasty or osteotomy

10

1kg weight loss = ______ reduction in load during ADLs

4x

11

True or false: Opioids have little to no use in arthritis

True

12

First line analgesic for OA

Acetaminophen (Tylenol)

13

Maximum dosage of Tylenol

4g/day
2g/day if chronic alcohol intake or underlying liver disease

14

What options do you have if Tylenol isn't treating OA pain?

- NSAIDs
- Viscosupplementation
- Topical analgesics → diclofenac gel, capsaicin
- Corticosteroid injections

15

True or false: NSAIDs work immediately

False
Analgesic effects begin within 1-2 hours, but anti-inflammatory effects may take 2-3 weeks

16

What counseling should you provide with NSAIDs?

GI complaints are common - take with food

17

Maximum of ___ corticosteroid injections in a joint. Why?

3 injections/joint/year due to increased cartilage degeneration

18

How do valgus braces help mediate pain relief?

Stabilize joint
Reduce muscle contractions and joint compressions

19

What is hyaluronic acid used for in OA?

Synthesized by synovial membrane, functions as lubricant and shock absorber → viscosupplementation for OA

20

Synvisc-One vs. Euflexxa

- Synvisc has higher risk of pseudo-septic reaction (knee effusion, inflammation, leukocytosis)
- Euflexxa better option b/c no pseudo-septic reaction

21

When would you use narcotics in DJD?

Post-op, NOT pre-op
? Short-term use in exacerbations