Osteoarthritis

Question 1

What is osteoarthritis?

Answer 1

Condition characterised by the progressive. loss of articular cartilage and remodelling of the underlying bone, usually due to wear
Leading cause of disability in the Western World

Question 2

Why is osteoarthritis on the increase?

Answer 2

Ageing population

Increasing rates of obesity

Question 3

What is the most mobile type of joint?

Answer 3

Synovial joint

Question 4

What type of cartilage is found at a synovial joint?

Answer 4

Hyaline cartilage

Question 5

What is hyaline cartilage composed of?

Answer 5

Type II collagen

Question 6

What is the role of synovial fluid?

Answer 6

Reduces friction during movement

Question 7

Why would joints wear more quickly?

Answer 7

Obesity
Increase in physical activity: high impact
Trauma: that fractures bone gives you rough surface
Loss of cartilage: Less absorption of shock

Question 8

What are the main features of type I collagen?

Answer 8

bONE

Found in fibrocartilage meniscus

Question 9

What are the main features of type II collagen?

Answer 9

Cartilage

Question 10

Describe the pathogenesis of osteoarthritis?

Answer 10

Wear process and secondary inflammation

Progressive loss of articular cartilage and remodelling of underlying bone

Due to the response

……………….

Question 11

What are the primary causes of osteoarthritis?

Answer 11

Female: advancing age and manual labour

Question 12

What are the signs of symptoms of osteoarthritis?

Answer 12

Gradual onset
Joint pain
Stiffness
Worsen at the end of day and with activity

Question 13

What are the signs of symptoms of osteoarthritis?

Answer 13

Gradual onset
Joint pain
Stiffness
Worsen at the end of day and with activity
Relieved by rest
Deformity

Question 14

What is varus deformity?

Answer 14

Excessive inward angulation

Knee towards the midline

Question 15

What is a valgus deformity?

Answer 15

Excessive outward anugaltion

Knee away from midline

Question 16

How can we manage osteoarthritis?

Answer 16

Physiotherapy
Steroid injections 
Pain killers 
Crutch/ Walking stick 
Surgery e.g. hip replacement

Question 17

What conservative approaches can be used?

Answer 17

Education
Physiotherapy
Weight loss
Hot and cold therapy

Question 18

What medical approaches can be used?

Answer 18

Simple analgesia
Topical NSAIDs
Injection- steroid & local anaesthetic

Question 19

What operative approaches can be used?

Answer 19

Realignment

Replacement

Question 20

What is the primary pathology in rheumatoid arthritis?

Answer 20

Inflammation

Secondary wear

Question 21

What is the primary pathology in osteoarthritis?

Answer 21

Wear process

Secondary inflammation

Question 22

Which type of arthritis presents symmetrically?

Answer 22

Rheumatoid arthritis

Question 23

During which time of the day do symptoms for osteoarthritis worsen?

Answer 23

Evening

Question 24

During which time of the day do symptoms for rheumatoid arthritis worsen?

Answer 24

Early morning

Question 25

What % increase in pressure is experience after a total meniscectomy?

Answer 25

800%

Question 26

What is the function of the meniscus?

Answer 26

Load distribution Prevents 'stiletto on ground' Shock absorber

Question 27

What are the key findings of OA seen on X-ray?

Answer 27

Osteophyte formation Joint space narrowing  Subchondral sclerosis: hardening of the bone just below the cartilage surface Subchondral cyst: fluid filled space inside a joint that extends from one bone of the joint  Deformity 

Question 28

What questions can you ask to explore pain?

Answer 28

Does the pain worsen as she does anything particular?Exacerbating factors When does the pain get better? Relieving factors At what time of day is the pain worse? Do you have pain at night?  What type of pain? Stabbing/sharp/dull/crushing/burning  Where is the pain exactly?  Does the pain radiate? Usually caused by injury to a nerve? Grade your pain from 0-10 (intensity)

Question 29

What non-operative approaches can be used for hallux valgus?

Answer 29

Orthotics | Space or custom shoes

Question 30

What operative approaches can be used for hallux valgus?

Answer 30

Osteotomy Athroplasty (replacement) Athrodesis (fusion)